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      Psychometric Validation of the Multidimensional Scale of Perceived Social Support During Pregnancy in Rural Pakistan

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          Abstract

          Background: The Multidimensional Scale of Perceived Social Support (MSPSS) is a short and reliable instrument that assesses perceived social support from the social network of an individual. A previous study in Pakistan among postpartum women has demonstrated a unidimensional factor structure in contrast to the original three-factor structure. The emergence of a one-factor structure for postpartum women in Pakistan may be due to traditional postpartum practices unique to the women of the subcontinent. Building upon the previous evidence, this study aims to explore the psychometric properties of MSPSS among pregnant women in their third trimester in rural Pakistan.

          Methods: A cross-sectional survey was conducted from October 2014 to February 2016, in rural Pakistan. A sample of 1,154 pregnant women (aged ≥ 18 years) in their third trimester who were registered with the local Lady Health Worker Program and were living in the north of the Punjab Province was included in this study. They were assessed using Urdu translated scales of Patient Health Questionnaire, MSPSS, Maternal Social Support Index, and Perceived Stress Scale. Principal Axis Factoring was used to assess the construct validity of the MSPSS.

          Results: The MSPSS scale showed an excellent internal consistency, yielding a Cronbach's α-value of 0.933. The MSPSS scale exhibited an excellent construct validity, and confirmatory factor analysis retained three factors (family, friends, and significant others) for both the depressed and non-depressed samples. Internal reliability and construct validity were also established.

          Conclusion: The psychometric findings suggest that the tridimensional structure of MSPSS is a valid and reliable measure of perceived social support among the Pakistani population with and without perinatal depression. The perceived social support is an important predictor of maternal mental well-being and psychopathologies, and the MSPSS can serve as a useful tool in mental health research in Pakistan.

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          Identifying the women at risk of antenatal anxiety and depression: A systematic review

          Alessandra Biaggi, Susan K. Conroy, Susan Pawlby … (2016)
          Background Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression. Methods A systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected. Results The most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss. Limitations The review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period. Conclusions The results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk.
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            FACTOR: a computer program to fit the exploratory factor analysis model.

            P Ferrando, Urbano Lorenzo-Seva (2006)
            Exploratory factor analysis (EFA) is one of the most widely used statistical procedures in psychological research. It is a classic technique, but statistical research into EFA is still quite active, and various new developments and methods have been presented in recent years. The authors of the most popular statistical packages, however, do not seem very interested in incorporating these new advances. We present the program FACTOR, which was designed as a general, user-friendly program for computing EFA. It implements traditional procedures and indices and incorporates the benefits of some more recent developments. Two of the traditional procedures implemented are polychoric correlations and parallel analysis, the latter of which is considered to be one of the best methods for determining the number of factors or components to be retained. Good examples of the most recent developments implemented in our program are (1) minimum rank factor analysis, which is the only factor method that allows one to compute the proportion of variance explained by each factor, and (2) the simplimax rotation method, which has proved to be the most powerful rotation method available. Of these methods, only polychoric correlations are available in some commercial programs. A copy of the software, a demo, and a short manual can be obtained free of charge from the first author.
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              Cognitive behaviour therapy-based intervention by community health workers for mothers with depression and their infants in rural Pakistan: a cluster-randomised controlled trial

              Atif Rahman, Abid Malik, Siham Sikander … (2008)
              Summary Background The treatment of perinatal depression is a public-health priority because of its high prevalence and association with disability and poor infant development. We integrated a cognitive behaviour therapy-based intervention into the routine work of community-based primary health workers in rural Pakistan and assessed the effect of this intervention on maternal depression and infant outcomes. Methods We randomly assigned 40 Union Council clusters in rural Rawalpindi, Pakistan, in equal numbers to intervention or control. Married women (aged 16–45 years) in their third trimester of pregnancy with perinatal depression were eligible to participate. In the intervention group, primary health workers were trained to deliver the psychological intervention, whereas in the control group untrained health workers made an equal number of visits to the depressed mothers. The primary outcomes were infant weight and height at 6 months and 12 months, and secondary outcome was maternal depression. The interviewers were unaware of what group the participants were assigned to. Analysis was by intention to treat. The study is registered as ISRCTN65316374. Findings The number of clusters per group was 20, with 463 mothers in the intervention group and 440 in the control group. At 6 months, 97 (23%) of 418 and 211 (53%) of 400 mothers in the intervention and control groups, respectively, met the criteria for major depression (adjusted odds ratio (OR) 0·22, 95% CI 0·14 to 0·36, p<0·0001). These effects were sustained at 12 months (111/412 [27%] vs 226/386 [59%], adjusted OR 0·23, 95% CI 0·15 to 0·36, p<0·0001). The differences in weight-for-age and height-for-age Z scores for infants in the two groups were not significant at 6 months (−0·83 vs −0·86, p=0·7 and −2·03 vs −2·16, p=0·3, respectively) or 12 months (−0·64 vs −0·8, p=0·3 and −1·10 vs −1·36, p=0·07, respectively). Interpretation This psychological intervention delivered by community-based primary health workers has the potential to be integrated into health systems in resource-poor settings. Funding Wellcome Trust.
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Psychol
                Journal ID (iso-abbrev): Front Psychol
                Journal ID (publisher-id): Front. Psychol.
                Title: Frontiers in Psychology
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 1664-1078
                Publication date (Electronic): 15 June 2021
                Publication date Collection: 2021
                Volume: 12
                Electronic Location Identifier: 601563
                Affiliations
                [1] 1Human Development Research Foundation , Islamabad, Pakistan
                [2] 2Department of Primary Care & Mental Health, Institute of Population Health, University of Liverpool , Liverpool, United Kingdom
                [3] 3Faculty of Research, Rawalpindi Medical University , Rawalpindi, Pakistan
                [4] 4Department of Population Health Science, Global Institute of Human Development, Shifa Tameer-e-Millat University , Islamabad, Pakistan
                [5] 5Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University , New Haven, CT, United States
                [6] 6Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill, NC, United States
                [7] 7Department of Public Health, Health Services Academy , Islamabad, Pakistan
                Author notes

                Edited by: Sai-fu Fung, City University of Hong Kong, China

                Reviewed by: Zeng-Jie Ye, Guangzhou University of Chinese Medicine, China; Nourossadat Kariman, Shahid Beheshti University of Medical Sciences, Iran

                *Correspondence: Ahmed Waqas ahmed.waqas@ 123456liverpool.ac.uk

                This article was submitted to Quantitative Psychology and Measurement, a section of the journal Frontiers in Psychology

                †These authors share last authorship

                Article
                DOI: 10.3389/fpsyg.2021.601563
                PMC ID: 8239233
                PubMed ID: 34211414
                SO-VID: 6e5b5b06-861b-4b04-8e8e-c79e9423a35b
                Copyright © Copyright © 2021 Sharif, Zaidi, Waqas, Malik, Hagaman, Maselko, LeMasters, Liaqat, Bilal, Bibi, Ahmad, Sikander and Rahman.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 12 October 2020
                Date accepted : 14 May 2021
                Page count
                Figures: 3, Tables: 5, Equations: 0, References: 41, Pages: 10, Words: 7555
                Funding
                Funded by: National Institute of Mental Health 10.13039/100000025
                Award ID: U19MH95687
                Categories
                Subject: Psychology
                Subject: Original Research

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: social support (mesh term),social support,validation,psychometric,antenatal depression,postpartum depression,perinatal depression
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: social support (mesh term), social support, validation, psychometric, antenatal depression, postpartum depression, perinatal depression

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