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dc.contributor.advisorCheyne, Helen-
dc.contributor.advisorMaxwell, Margaret-
dc.contributor.advisorO'Carroll, Ronan-
dc.contributor.authorSinesi, Andrea-
dc.identifier.citationSinesi, A., Maxwell, M., O’Carroll, R., & Cheyne, H. (2019). Anxiety scales used in pregnancy: Systematic review. British Journal of Psychiatry Open, 5(1), 1–13.
dc.description.abstractBackground: Anxiety during pregnancy is a strong predictor of postnatal depression and can negatively impact on a range of child developmental outcomes. Recent reviews highlight the lack of anxiety measures with robust psychometric properties for screening use in pregnancy. Aim: This research aimed to develop a brief self-report scale specifically constructed to identify problematic anxiety symptoms in pregnant women, and conduct preliminary psychometric testing of the scale. Method: The development and psychometric validation of the SAAS (Stirling Antenatal Anxiety Scale) was informed by five studies. A systematic review of the psychometric literature and interviews with women with experience of problematic anxiety symptoms in pregnancy both contributed to the generation of an initial item pool for the assessment of the target construct. This was subsequently refined and reduced, using a Delphi technique involving key informants (i.e. expert opinion and target population). The screening accuracy of the final, 10-item version of the scale was subsequently tested against a diagnostic interview, and compared to the NICE-recommended screening scales for antenatal anxiety (GAD-2/7). The internal consistency, factor structure and construct validity of the SAAS were also assessed. Results: 174 women completed the SAAS, GAD-2/7 and Edinburgh Postnatal Depression Scale (EPDS). The SAAS was found to have excellent sensitivity (91%) and very good specificity (85%) at its optimal cut-off score of ≥ 8. It also showed a superior screening performance when compared to both the GAD-2 and the GAD-7 at their NICE-recommended cut-off scores. Its internal consistency was close to excellent (α = 0.88), and the scale exhibited a single-factor structure. The SAAS was also considered highly acceptable to pregnant women (mean score = 9.48; range 1-10). Conclusion: The SAAS shows promise as a brief, acceptable and effective screening tool for antenatal anxiety, which may improve identification and aid appropriate targeting of resources and care.en_GB
dc.publisherUniversity of Stirlingen_GB
dc.rightsThe scale developed as part of this thesis (SAAS: Stirling Antenatal Anxiety Scale) is a creation of Andrea Sinesi, Helen Cheyne, Margaret Maxwell, Ronan O’Carroll, University of Stirling. Available on request by contacting the first author at All rights reserved.en_GB
dc.subjectpregnancy-related anxietyen_GB
dc.subjectpregnancy-specific anxietyen_GB
dc.subjectStirling Antenatal Anxiety Scale (SAAS)en_GB
dc.subjectpsychometric propertiesen_GB
dc.subjectscreening toolen_GB
dc.subjectscale developmenten_GB
dc.subjectclassical test theoryen_GB
dc.subject.lcshHospitals Maternity services Standards Scotlanden_GB
dc.subject.lcshPrenatal care Scotland.en_GB
dc.subject.lcshPregnancy Physiological aspectsen_GB
dc.subject.lcshPregnancy Complicationsen_GB
dc.titleThe development and initial validation of a screening scale for antenatal anxietyen_GB
dc.typeThesis or Dissertationen_GB
dc.type.qualificationnameDoctor of Philosophyen_GB
dc.rights.embargoreasonResearch articles will be published from thesisen_GB
dc.contributor.funderChief Scientist Office (CSO) Doctoral Training Fellowship - DTF/15/03en_GB
Appears in Collections:Faculty of Health Sciences and Sport eTheses

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