Matern Child Health J DOI 10.1007/s10995-014-1630-9
Evaluation of the French Version of the Multidimensional Scale of Perceived Social Support During the Postpartum Period A. Denis • S. Callahan • M. Bouvard
Ó Springer Science+Business Media New York 2014
Abstract In the presence of physical and psychological disturbances in the postpartum period, perceived social support is often regarded as a protective factor in women’s mental health. This work evaluates the psychometric properties of the French version of a questionnaire widely used internationally to measure perceived social support, which has not been yet validated in French: the Multidimensional Scale of Perceived Social Support (MSPSS). This study collected data from 148 women (30.5 ± 5.12 years) who agreed to complete the MSPSS and a scale assessing symptoms of postpartum depression (Edinburgh Post-Natal Depression Scale, EPDS) 1 and 4 months after childbirth. The results confirm the original three-factor structure of the scale. The Cronbach’s alpha coefficients are excellent. The total scale score is correlated with all three dimensions and a significantly negative correlation is found between MSPSS and EPDS. The results suggest that the French tool has generally good internal reliability. The MSPSS can provide useful data helping to identify French-speaking people at risk for negative feelings (e.g., mood disorders of perinatal period).
A. Denis (&) Laboratoire InterUniversitaire de Psychologie (LIP), UFR LLSH – LIP, Universite´ de Savoie, Domaine Jacob Bellecombette, BP 1104, 73011 Chambe´ry Cedex, France e-mail: [email protected] S. Callahan Centre d’e´tudes et de recherches en psychopathologie (CERPP), Universite´ Toulouse II le Mirail, Toulouse, France M. Bouvard Laboratoire de psychologie et neurocognition (LPNC), Universite´ de Savoie, Chambe´ry, France
Keywords Perceived social support MSPSS Motherhood Postnatal depression
Introduction The postnatal period is characterized by many physiological changes that result in the development of more or less intense psychological disturbances in women: postpartum blues, postnatal depression, brief episode of postpartum psychosis [1] or even posttraumatic stress disorder following childbirth [2]. In France, the prevalence of postnatal depression is approximately 17 % [3] and 5 % for posttraumatic stress disorder [2]. Psychological disturbance associated with childbirth and the postnatal period is not inevitable but social support is thought to be an important influence on women’s mental health in this specific period. Social support is defined as the general availability of friends and family members providing psychological and material resources [4]. The authors make the distinction between perceived social support and received social support. Many factors related to the risk of developing psychological symptoms after childbirth have been identified but several studies advance the deleterious repercussions of a perceived lack of social support on maternal mental health. Studies suggest that depressed women have fewer supportive figures than the other mothers [5]; and they report less support from their spouse, either emotional or instrumental [6]. Recent studies have confirmed these observations. Depressed mothers receive less social support, in particular from their spouse [7] and feel more socially isolated [8]. Lemola et al. [9] found that women reporting high levels of perceived social support during postpartum were less likely to develop depression and post-traumatic stress symptoms 5 months
123
Matern Child Health J
postpartum. Two recent studies examined the relationship between postnatal depression symptoms and social support using a specific perceived social support scale: the Multidimensional Scale of Perceived Social Support (MSPSS) [10, 11]. The prevalence of perceived symptoms of postnatal depression was negatively correlated with perceived social support in both of them. The MSPSS is a self-administered questionnaire designed to measure perceived social support that was originally developed in 1988 by Zimet et al. [12]. Composed of 12 items, the MSPSS measures perceived social support from three sources: family, friends and significant others. Most studies agree with a three-dimensional structure of the MSPSS; this structure was found with both clinical and nonclinical samples of adolescents [13–15], students [16–21] and adults [22–25]. Only two exploratory studies have highlighted a two-dimensional model: a study on elderly suffering from generalized anxiety disorder [26], and a Chinese study conducted with adolescents [27]. In recent years, several studies have proposed foreign language versions of this tool: Malaysian adaptation [28], Chinese [27], Turkish [20], African [29] and Italian [30]. To our knowledge, six studies have examined the factor structure of the MSPSS using confirmatory factor analysis [16, 17, 19, 22, 24, 29]. All were in favour of a three-dimensional structure. The MSPSS has been the subject of numerous investigations since its development and initial use. While the prepartum period was previously investigated with this tool [25], no validation study has focused on postpartum women. Several French studies used MSPSS translations during postpartum period without references of psychometric properties [2, 31–34]. In comparison with existing social support scales, the MSPSS is a very short scale that is well accepted by participants, particularly by new mothers. A French validation of MSPSS could be useful, as a complement to existing blues symptoms scales, for identifying French-speaking women at risk in the immediate postpartum. This internationally well accepted tool could be very useful both for clinical and research fields. Moreover, the results could also complete works about cross-cultural validity of MSPSS.
Methodology Participants Women who participated in the study were solicited during their stay in a French university maternity service, in the South of France. Two days postpartum, participants completed a protocol composed of basic demographic information and accepted to be contacted again by mail at 1 month (time 1) and at 4 months (time 2) postpartum to complete the French version of the MSPSS and a scale
123
Table 1 Socio-biographical and gynecological characteristics of the sample (N = 148) Variables
N = 148 n (%)
Professional activity
121 (81.76)
Partnership status Celibate As a couple, with the baby’s father
3 (2.03) 145 (97.97)
Primiparity
87 (58.78)
Hospitalizations during pregnancy
32 (21.62)
Lenght of pregnancy Less than 36 weeks
22 (14.86)
More than 36 weeks
126 (85.14)
Type of delivery Vaginal
95 (64.19)
Vaginal with instruments
22 (14.86)
Cesarean
31 (20.94)
Type of anesthesia None
21 (14.19)
Epidural
124 (83.78)
General
3 (2.03)
Gender of the baby Male
77 (52.03)
Female
71 (47.97)
assessing depressive postnatal symptoms (EPDS). Among the 210 women asked to participate, 36 refused participation based on the longitudinal protocol (commitment seen as being too constraining) and 26 participants had to be removed from the sample because they did not complete the questionnaires at time 2. At 1 month postpartum (time 1), no significant difference was found on the EPDS (z = 0.28; p = 0.77) and the MSPSS scores (z = -0.15; p = 0.87) between the women who didn’t complete questionnaires at time 2 and the other women. The final sample consisted of 148 women aged 30.5 years on average (SD = 5.12; min = 20, max = 45). Socio-biographical and gynaecological characteristics of the sample are presented in Table 1. All women were contacted on the maternity ward by the first author of the study and signed a consent form agreeing to participate (Anne Denis, psychologist). The study was developed in coordination with the hospital; approval for this non-intervention-based-research was provided by the local institutional board. The research fulfilled the national laws regarding ethics and research. Measuring Instruments The Multidimensional Scale of Perceived Social Support (MSPSS; Zimet et al. [12]) is a self-administered
Matern Child Health J
questionnaire consisting of 12 items that assess perceived social support from three sources: the family (FAM) (for example item 3: ‘‘My family really tries to help me’’), friends (FRI) (for example item 7 ‘‘I can count on my friends when things go wrong’’) and significant others (SO) (for example item 10 ‘‘There is a special person in my life who cares about my feelings’’). Participants indicate their level of agreement or disagreement with the items using a seven-point Likert scale ranging from 1 (completely disagree) to 7 (strongly agree). Each of the three dimensions (FAM, FRI, SO) has four items and sub-dimensional scores vary from 4 to 28 points. A high score on each of these subdimensions indicates high perceived social support. The Edinburgh Post-Natal Depression Scale (EPDS) is a self-administered questionnaire identifying postnatal depression symptoms using 10 Likert-type items (for example, item 1, ‘‘In the past 7 days, I have been able to laugh and see the funny side of things: As much as I always could (0); Not quite so much now (1); Definitely less than I used to (2); Hardly at all (3)’’). The range of possible scores varies from 0 to 30. Developed by Cox et al. [35], the EPDS has been validated in French by Guedeney and Fermanian in 1998 [36]. The threshold commonly used for indicating the presence of postnatal depression is 12 [3]. The internal consistency of the EPDS is in the current study was quite satisfactory (a = 0.87). Translation Procedure A parallel back-translation procedure was used to adapt the MSPSS in French. A first translation from English to French was established by a French person (AD, university student). A second person, native English speaker (SC, university professor) translated the French translation without referring to the original version (blind back translation). Finally, the two versions in English (original version and version obtained by back-translation) were compared and studied by the authors to ensure the absence of inaccuracy. A final reading of the items was made by French scholars to make the final corrections. The final version is presented in ‘‘Appendix’’.
and (e) the Standardized Root Mean Square Residual (SRMR) (standard: \0.08) [38]. Finally, the fidelity of the instrument was tested using Cronbach’s alpha, Pearson’s correlations and Repeated Measures t tests. The results were analysed using SPSS Amos, Version 20.
Results Homogeneity of the Sample Because the sample included women with different sociobiographical and gynecological characteristics, Chi-square tests were conducted to confirm the homogeneity of the sample. No significant differences were found with regard to marital status (Chi-square = 23.79; p = 0.97), primiparity (v2 = 41.89; p = 0.35), preterm birth (v2 = 27.29; p = 0.92) or hospitalization during pregnancy (v2 = 44.6; p = 0.25). Confirmatory Factor Analysis A confirmatory factor analysis was performed on the data observed at 1 month postpartum (T1) to test the three factor structure proposed by Zimet et al. [25] and confirmed by six recent studies [16, 17, 19, 22, 24, 29]. Despite AGFI (0.8) and Chi-2/ddl (144.36/51 = 2.83) values slightly lower than usually found in the literature, the results remain satisfactory (CFI = 0.95; RMSEA = 0.08; SRMR = 0.04). Internal Consistency The internal consistency of the French version is quite satisfactory both in terms of total questionnaire (a = 0.92) as well as for each of the three sub-dimensions (a = 0.94 for the FAM dimension; a = 0.91 for the FRI dimension and a = 0.92 for the SO dimension). Correlation Analysis at Time 1 and Test–Retest Reliability
Statistical Analysis The homogeneity of the sample was tested using Chi-square tests. A confirmatory factor analysis was performed to test the original three factor model of the MSPSS. The fit indices used to evaluate the overall model were (a) the Chisquare model divided by the degree of freedom (Chi-2/ddl) (standard:\2) [37], (b) the Adjusted Goodness of Fit Index (AGFI) (standard:[0.9) [37], (c) the Comparative Fit Index (CFI) (standard: C0.95) [38], (d) the Root Mean Square Error of approximation (RMSEA) (standard: B0.08) [39]
Descriptive statistics and correlation analysis were performed on the total score of the MSPSS and each subscores observed in MSPSS at time 1 (Table 2). The total MSPSS score is positively correlated with each of the three sub-dimensions of MSPSS. The mean EPDS score was 8.22 (SD = 5.64). Thirtyseven women (25 %) had scores equal or superior to 12, which as noted above is an indicator of postnatal depression [3]. A significant negative correlation was noted between MSPSS and the postpartum depression symptoms
123
Matern Child Health J Table 2 Descriptive statistics of the Multidimensional Scale of Perceived Social Support (MSPSS) and correlations between the MSPSS and the Edinburgh Postnatal Depression Scale (EPDS) obtained 1 month post-partum (N = 148) Variable
M
SD
Correlations MSPSS total
MSPSS total
68.82
Friends
Significant other
13.22
Family
22.06
6.27
0.85*
Friends Significant Other
22.13 24.7
5.03 4.79
0.77* 0.84*
8.22
5.64
-0.17*
EPDS
Family
0.42* 0.58* -0.12
0.53* -0.18*
-0.11
MSPSS Multidimensional Scale of Perceived Social Support, EPDS Edinburgh Postnatal Depression Scale * Correlation significant at p \ 0.05
Table 3 Correlations between the total score and the sub-scores of the Multidimensional Scale of Perceived Social Support (MSPSS) obtained 1 month post-partum (T1) and 4 months post-partum (T2) (N = 148)
MSPSS total (T2)
MSPSS total (T1)
Family (T1)
Friends (T1)
SO (T1)
0.55*
0.52*
0.4*
0.41*
Family
0.46*
0.68*
0.14*
0.24*
Friends
0.46*
0.23*
0.61*
0.33*
SO
0.35*
0.25*
0.21*
0.43*
MSPSS Multidimensional Scale of Perceived Social Support, SO significant other * Correlation significant at p \ 0.05
Table 4 Comparison of the average scores obtained on the Multidimensional Scale of Perceived Social Support (MSPSS) 1 month post-partum (T1) and 4 months post-partum (T2) (N = 148) T1
MSPSS total
T2
M
SD
M
SD
69.26
t(147)
p
68.82
13.22
12.85
-0.43
0.67
Family
22.06
6.27
22
6.38
0.15
0.88
Friends SO
22.13 24.69
5.03 4.79
22.01 25.26
5.33 4.53
0.3 -1.38
0.76 0.17
MSPSS Multidimensional Scale of Perceived Social Support, SO significant other
scale (r = -0.17). Regarding the sub-dimensions, only the FRI sub-dimension was correlated with the level of postpartum depression symptoms (r = -0.18). Analyses of correlations were made between the total MSPSS scores and subscales scores obtained at 1 month (T1) and at 4 months postpartum (T2). All correlations were significantly positive (Table 3). No significant difference was observed between the average MSPSS score obtained at time 1 and the average score obtained at time 2 (Table 4). Table 5 presents the factor loadings for all the items at the two time points.
123
Discussion The results of this study suggest that the French version of the MSPSS can be considered to be a reliable and valid instrument for measuring perceived social support among young French mothers. The hypothesis for a three-factor structure was confirmed in this French sample. Concerning the principal gynaecological characteristics of the mothers, the proportion of delivery mode (79 % vaginal delivery; 21 % caesarean sections) as well as use of epidural anaesthesia were similar to results from another French study [2]. Concerning postnatal depression symptoms, the observed rate was in keeping with previous studies as mentioned by Gaillard et al. [3]. These results suggest good representativeness of the sample. Regarding the confirmatory factor analysis of the French version, three of the indicators calculated suggest a good model fit. The CFI (0.95) was acceptable according to the standard recommended by Hu and Bentler (C0.95) [38] and was comparable to those found in all six confirmatory studies [16, 17, 19, 22, 24, 29]. The RMSEA (0.08) was also acceptable according to MacCallum et al.’s criteria (standard: B0.08) [39]. While two studies reported a RMSEA slightly lower than the one found in our sample [22, 29], this result is comparable to the work of Duru [19], Clara et al. [17] and Vaingankar et al. [24]. Finally, concerning the SRMR (0.04), this index was indicated only in the studies by Duru [19] and Cheng and Chan [16]. It was comparable to the one reported in these two studies and is acceptable according to the criteria proposed by Hu and Bentler (standard: \0.08) [38]. Two indices, however, were slightly outside the recommended standards. The AGFI index in the current (AGFI = 0.8) was lower than the standard recommended by Tabachnick and Fidell ([0.9) [37]. Of the six confirmation studies on the MSPSS, only three studies reported the AGFI index. While the AGFI calculated in this study is comparable to the one found in the clinical sample of Clara et al. [17], it is less optimal than the one found by
Matern Child Health J Table 5 Means (M), standard deviations (SD), item-total correlations (r), and factor loadings of MSPSS items 1 month post-partum (Time 1) and 4 months post-partum (Time 2) (N = 148) Items
M
SD
r
F1
F2
F3
There is a special person who is around when I am in need
6.07
1.4
0.73
0.24
0.21
0.82*
There is a special person with whom I can share my joys and sorrows
6.14
1.33
0.77
0.24
0.26
0.84*
My family really tries to help me
5.64
1.63
0.8
0.86*
0.14
0.32
I get the emotional help and support I need from my family
5.47
1.65
0.81
0.89*
0.14
0.30
I have a special person who is a real source of comfort to me
6.16
1.32
0.78
0.27
0.29
0.80*
My friends really try to help me I can count on my friends when things go wrong
5.26 5.48
1.36 1.44
0.64 0.68
0.14 0.15
0.78* 0.86*
0.21 0.18
Time 1
I can talk about my problems with my family
5.62
1.63
0.81
0.86*
0.31
0.18
I have friends with whom I can share my joys and sorrows
5.69
1.38
0.72
0.15
0.86*
0.25
There is a special person in my life who cares about my feelings
6.3
1.26
0.73
0.27
0.17
0.83*
My family is willing to help me make decisions
5.31
1.81
0.74
0.87*
0.13
0.21
I can talk about my problems with my friends
5.64
1.42
0.72
0.19
0.88*
0.20
There is a special person who is around when I am in need
6.32
1.25
0.76
0.21
0.25
0.87*
There is a special person with whom I can share my joys and sorrows
6.29
1.24
0.77
0.30
0.21
0.85*
My family really tries to help me
5.66
1.63
0.73
0.07
0.91*
0.21
I get the emotional help and support I need from my family
5.45
1.7
0.78
0.15
0.92*
0.21
I have a special person who is a real source of comfort to me
6.28
1.29
0.74
0.23
0.19
0.88*
My friends really try to help me
5.35
1.32
0.69
0.83*
0.20
0.18
Time 2
I can count on my friends when things go wrong
5.42
1.48
0.71
0.91*
0.11
0.22
I can talk about my problems with my family I have friends with whom I can share my joys and sorrows
5.47 5.64
1.69 1.47
0.76 0.71
0.25 0.88*
0.88* 0.06
0.12 0.31
There is a special person in my life who cares about my feelings
6.35
1.18
0.63
0.16
0.17
0.79*
My family is willing to help me make decisions
5.4
1.77
0.74
0.09
0.88*
0.25
I can talk about my problems with my friends
5.56
1.47
0.72
0.89*
0.18
0.18
N = 148. Salient factor loadings ([0.4) are flagged (*)
Vaingankar et al. (0.91) [24] and Bruwer et al. [29]. The comparison with these two models, however, is problematic because of differing samples. While the current study focuses on post-partum mothers, the Vaingankar et al. study [24] was conducted among patients with schizophrenia and the Bruwer et al. study [29] carried out on adolescents aged from 11.3 to 23.5 years. Regarding the Chi-square model divided by the degree of freedom, Tabachnick and Fidell [37] recommend a threshold less than or equal to 2 to determine good fit. As is the case in the current study, most confirmatory studies report higher values: 2.66 for Aroian et al. [22]; 3.79 for Clara et al. [17] in a clinical sample; 4.5 Duru [19]; 10,69 Cheng and Chan [16]; and the index was not reported in the studies by Bruwer et al. [29] and Vaingankar et al. [24]. Cronbach alphas for the full scale and for each subdimension (all a [ 0.9) confirm the apparently good internal consistency of the French version of the MSPSS. These coefficients are quite similar to those of the original
version [25]: a = 0.92 for the total scale and, respectively, 0.9, 0.94 and 0.9 for the FAM, FRI and SO dimensions. Concerning test–retest results, if all the correlations between the two measurement times are significantly positive, it should to be noted that these correlations are too weak to confirm the stability of the tool at 12 weeks (r = 0.54 for total score and r = 0.68, r = 0.61, r = 0.43 respectively for the FAM, FRI and SO dimensions). After verification, no significant difference was found between time 1 and time 2 scores. It is possible that this result is due to the specific context of post-partum. Indeed, 1 month after delivery, mothers were still on maternity leave whereas, 4 months after giving birth, most of them had returned to work. This contextual difference along with the novelty of being a mother could have had an impact on the results. Spiteri and Borg Xuereb [40] noted that women suffered from lack of received social support at their place of work. These women recognized that this transition affected their overall health.
123
Matern Child Health J
Finally, the divergent validity of the MSPSS is confirmed by a low and significant negative correlation found between depressive postpartum symptoms and perceived social support. As the literature shows, the feeling of lack of perceived social support is linked to postnatal depression symptomatology [10, 11, 41]. An analysis of the dimensions suggests that the lack of perceived social support from friends is most closely linked to postnatal depression symptoms (the only dimension for which a correlation was found). Some studies report that women generally perceive more support from their friends and from a significant other than from their families [12]. Future research should be undertaken in order to better evaluate the perceived influence of different sources of social support during the postpartum period. The French version of the MSPSS should also be tested in other samples with differing characteristics. In conclusion, the MSPSS is a quickly implemented and internationally well-accepted tool. The French version can provide a specific indicator for French-speaking women of perceived social support that can be used in research and in applied clinical settings during the postpartum period. Moreover, the confirmation of a three-factor structure for the French tool could suggest, in addition of several foreign language versions, the cross-cultural validity of MSPSS.
Appendix See Table 6.
Table 6 French translation of the Multidimensional Scale of Perceived Social Support 1. Il y a une personne en particulier qui est la` quand j’en ai besoin (APS) 2. Il y a une personne en particulier avec laquelle je peux partager mes joies et mes peines (APS) 3. Ma famille essaie vraiment de m’aider (F) 4. Je rec¸ois de ma famille toute l’aide e´motionnelle et le soutien dont j’ai besoin (F) 5. Je connais une personne en particulier qui est une vraie source de re´confort pour moi (APS) 6. Mes amis essaient vraiment de m’aider (A) 7. Je peux compter sur mes amis quand les choses vont mal (A) 8. Je peux parler de mes proble`mes avec ma famille (F) 9. J’ai des amis avec lesquels je peux partager mes joies et mes peines (A) 10. Il y a quelqu’un de spe´cial dans ma vie qui s’inquie`te de ce que je ressens (APS) 11. Ma famille est preˆte a` m’aider a` prendre des de´cisions (F) 12. Je peux parler de mes proble`mes avec mes amis (A) APS autre personne significative, F famille, A amis
123
References 1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder—4th edition revised (DSM-IVR). Washington, DC: APA. 2. Denis, A., Parant, O., & Callahan, S. (2011). Frequency of and risk factors for post-traumatic stress disorder related to birth: A prospective longitudinal study in a French population. Journal of Reproductive and Infant Psychology, 29(2), 125–135. 3. Gaillard, A., Le Strat, Y., Mandelbrot, L., Keita, H., & Dubertret, C. (2014). Predictors of postpartum depression: Prospective study of 264 women followed during pregnancy and postpartum. Psychiatry Research, 215(2), 341–346. 4. Kleiman, E. M., & Riskind, J. H. (2013). Utilized social support and self-esteem mediate the relationship between perceived social support and suicide ideation. A test of a multiple mediator model. Crisis, 34(1), 42–49. 5. Stein, A., Cooper, P. J., Campbell, E. A., Day, A., & Altman, P. E. A. (1989). Social adversity and perinatal complications: Their relation to postnatal depression. British Medical Journal, 298, 1073–1074. 6. O’Hara, M. W. (1986). Social support, life events and depression during pregnancy and the puerperium. Archive of General Psychiatry, 43, 569–573. 7. Se´journe´, N., Beaume´, M., Vaslot, V., & Chabrol, H. (2012). Effets du conge´ de paternite´ sur la de´pression du post-partum maternelle. Gyne´cologie Obste´trique et Fertilite´, 40, 360–364. 8. Husain, N., Cruickshank, K., Husain, M., Khan, S., Tomenson, B., & Rahman, A. (2012). Social stress and depression during pregnancy and in the postnatal period in British Pakistani mothers: A cohort study. Journal of Affective Disorders, 140, 268–276. 9. Lemola, S., Stadlmayr, W., & Grob, A. (2007). Maternal adjustment five months after birth: The impact of the subjective experience of childbirth and emotional support from the partner. Journal of Reproductive and Infant Psychology, 25(3), 190–202. 10. Ege, E., Timur, S., Zincir, H., Geckil, E., & Sunar-Reeder, B. (2008). Social support and symptoms of postpartum depression among new mothers in Eastern Turkey. Journal of Obstetrics and Gynaecology Research, 34(4), 585–593. 11. Yagmur, Y., & Ulukoca, N. (2010). Social support and postpartum depression in low-socioeconomic level postpartum women in Eastern Turkey. International Journal of Public Health, 55(6), 543–549. 12. Zimet, G. D., Dalhem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30–41. 13. Canty-Mitchell, J., & Zimet, G. D. (2000). Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents. American Journal of Community Psychology, 28, 391–400. 14. Edwards, L. M. (2004). Measuring perceived social support in Mexican American youth: Psychometric properties of the Multidimensional Scale of Perceived Social Support. Hispanic Journal of Behavioral Sciences, 26, 187–194. 15. Ramaswamy, V., Aroian, K. J., & Templin, T. N. (2009). Adaptation and psychometric evaluation of the Multidimensional Scale of Perceived Social Support for Arab American Adolescents. American Journal of Community Psychology, 43, 49–56. 16. Cheng, S. T., & Chan, A. C. M. (2004). The multidimensional scale of perceived social support: Dimensionality and age and gender differences in adolescents. Personality and Individual Differences, 37(7), 1359–1369. 17. Clara, I. P., Cox, B., Murray, W. E., Murray, L. T., & Torgrudc, L. J. (2003). Confirmatory factor analysis of the Multidimensional Scale of Perceived Social Support in clinically distressed
Matern Child Health J
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
and student samples. Journal of Personality Assessment, 81(3), 265–270. Dahlem, N. W., Zimet, G. D., & Walker, R. R. (1991). The Multidimensional Scale of Perceived Social Support: A confirmation study. Journal of Clinical Psychology, 47, 756–761. Duru, E. (2007). Re-examination of the psychometric characteristics of the multidimensional scale of perceived social support among Turkish university students. Social Behavior and Personnality, 35(4), 443–452. Eker, D., & Arkar, H. (1995). Perceived social support: Psychometric properties of the MSPSS in normal and pathological groups in a developing country. Social Psychiatry and Psychiatric Epidemiology, 30, 121–126. Kasarian, S. S., & McCabe, S. B. (1991). Dimensions of social support in the MSPSS: Factorial structure, reliability, and theoretical implications. Journal of Community Psychology, 19, 150–160. Aroian, K., Templin, T. N., & Ramaswamy, V. (2010). Adaptation and psychometric evaluation of the Multidimensional Scale of Perceived Social Support for Arab immigrant women. Health Care for Women International, 31, 153–169. Cecil, H., Stanley, M. A., Carrion, P. G., & Swann, A. (1995). Psychometric properties of the MSPSS and NOS in psychiatric outpatients. Journal of Clinical Psychology, 51, 593–602. Vaingankar, J. A., Abdin, E., & Chong, S. A. (2012). Exploratory and confirmatory factor analyses of the Multidimensional Scale of Perceived Social Support in patients with schizophrenia. Comprehensive Psychiatry, 53, 286–291. Zimet, G. D., Powel, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characte´ristics of the Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 55(3&4), 610–617. Stanley, M. A., Beck, J. G., & Zebb, B. J. (1998). Psychometric properties of the MSPSS in older adults. Aging and Mental Health, 2, 186–193. Chou, K. L. (2000). Assessing Chinese adolescents’ social support: The Multidimensional Scale of Perceived Social Support. Personality and Individual Differences, 28(2), 299–307. Ng, C. G., Amer Siddiq, A. N., Aida, S. A., Zainal, N. Z., & Koh, O. H. (2010). Validation of the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among a group of medical students in Faculty of medicine. Asian Journal of Psychiatry, 3(1), 3–6. Bruwer, B., Emsley, R., Kidd, M., Lochner, C., & Seedat, S. (2008). Psychometric properties of the Multidimensional Scale of
30.
31.
32. 33.
34.
35.
36.
37. 38.
39.
40.
41.
Perceived Social Support in youth. Comprehensive Psychiatry, 49(2), 195–201. Prezza, M., & Pacilli, M. G. (2002). Perceived social support from significant others, family and friends and several sociodemographic characteristics. Journal of Community and Applied Social Psychology, 12, 422–429. Callahan, S., & Denis, A. (2013). Irrational beliefs and motherhood: ‘‘Hot cognitions’’ and their relationship to perinatal psychopathology. Journal de The´rapie Comportementale et Cognitive, 23(1), 3–8. Minnes, S., Singer, L. T., Humphrey-Wall, R., & Satayathum, S. (2008). Child Abuse and Neglect, 32(3), 353–366. Se´journe´, N., Beaume, M., Vaslot, V., & Chabrol, H. (2012). Effets du conge´ de paternite´ sur la de´pression du post-partum maternelle. Gyne´cologie Obste´trique & Fertilite´, 40(6), 360–364. Se´journe´, N., Vaslot, V., Beame´, M., Goutaudier, N., & Chabrol, H. (2012). The impact of paternity leave and paternal involvement in child care on maternal postpartum depression. Journal of Reproductive and Infant Psychology, 30(2), 135–144. Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. Guedeney, N., & Fermanian, J. (1998). Validation study of the French version of the Edinburgh Post-Natal Depression Scale (EPDS): New results about use and psychometric properties. European Psychiatry, 13, 83–89. Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). New York: Allyn and Bacon. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis. Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1(2), 130–149. Spiteri, G., & Borg Xuereb, R. (2012). Going back to work after childbirth: Women’s lived experiences. Journal of Reproductive and Infant Psychology, 30(2), 201–216. Guedeney, N., Jacquemain, F., & Glangeaud-Freudenthal, M.-C. (2000). Le roˆle des facteurs environnementaux, de la vulne´rabilite´ individuelle et du support social dans le risque de survenue des de´pressions du post-partum. Devenir, 12, 13–33.
123
Evaluation of the French Version of the Multidimensional Scale of Perceived Social Support During the Postpartum Period A. Denis • S. Callahan • M. Bouvard
Ó Springer Science+Business Media New York 2014
Abstract In the presence of physical and psychological disturbances in the postpartum period, perceived social support is often regarded as a protective factor in women’s mental health. This work evaluates the psychometric properties of the French version of a questionnaire widely used internationally to measure perceived social support, which has not been yet validated in French: the Multidimensional Scale of Perceived Social Support (MSPSS). This study collected data from 148 women (30.5 ± 5.12 years) who agreed to complete the MSPSS and a scale assessing symptoms of postpartum depression (Edinburgh Post-Natal Depression Scale, EPDS) 1 and 4 months after childbirth. The results confirm the original three-factor structure of the scale. The Cronbach’s alpha coefficients are excellent. The total scale score is correlated with all three dimensions and a significantly negative correlation is found between MSPSS and EPDS. The results suggest that the French tool has generally good internal reliability. The MSPSS can provide useful data helping to identify French-speaking people at risk for negative feelings (e.g., mood disorders of perinatal period).
A. Denis (&) Laboratoire InterUniversitaire de Psychologie (LIP), UFR LLSH – LIP, Universite´ de Savoie, Domaine Jacob Bellecombette, BP 1104, 73011 Chambe´ry Cedex, France e-mail: [email protected] S. Callahan Centre d’e´tudes et de recherches en psychopathologie (CERPP), Universite´ Toulouse II le Mirail, Toulouse, France M. Bouvard Laboratoire de psychologie et neurocognition (LPNC), Universite´ de Savoie, Chambe´ry, France
Keywords Perceived social support MSPSS Motherhood Postnatal depression
Introduction The postnatal period is characterized by many physiological changes that result in the development of more or less intense psychological disturbances in women: postpartum blues, postnatal depression, brief episode of postpartum psychosis [1] or even posttraumatic stress disorder following childbirth [2]. In France, the prevalence of postnatal depression is approximately 17 % [3] and 5 % for posttraumatic stress disorder [2]. Psychological disturbance associated with childbirth and the postnatal period is not inevitable but social support is thought to be an important influence on women’s mental health in this specific period. Social support is defined as the general availability of friends and family members providing psychological and material resources [4]. The authors make the distinction between perceived social support and received social support. Many factors related to the risk of developing psychological symptoms after childbirth have been identified but several studies advance the deleterious repercussions of a perceived lack of social support on maternal mental health. Studies suggest that depressed women have fewer supportive figures than the other mothers [5]; and they report less support from their spouse, either emotional or instrumental [6]. Recent studies have confirmed these observations. Depressed mothers receive less social support, in particular from their spouse [7] and feel more socially isolated [8]. Lemola et al. [9] found that women reporting high levels of perceived social support during postpartum were less likely to develop depression and post-traumatic stress symptoms 5 months
123
Matern Child Health J
postpartum. Two recent studies examined the relationship between postnatal depression symptoms and social support using a specific perceived social support scale: the Multidimensional Scale of Perceived Social Support (MSPSS) [10, 11]. The prevalence of perceived symptoms of postnatal depression was negatively correlated with perceived social support in both of them. The MSPSS is a self-administered questionnaire designed to measure perceived social support that was originally developed in 1988 by Zimet et al. [12]. Composed of 12 items, the MSPSS measures perceived social support from three sources: family, friends and significant others. Most studies agree with a three-dimensional structure of the MSPSS; this structure was found with both clinical and nonclinical samples of adolescents [13–15], students [16–21] and adults [22–25]. Only two exploratory studies have highlighted a two-dimensional model: a study on elderly suffering from generalized anxiety disorder [26], and a Chinese study conducted with adolescents [27]. In recent years, several studies have proposed foreign language versions of this tool: Malaysian adaptation [28], Chinese [27], Turkish [20], African [29] and Italian [30]. To our knowledge, six studies have examined the factor structure of the MSPSS using confirmatory factor analysis [16, 17, 19, 22, 24, 29]. All were in favour of a three-dimensional structure. The MSPSS has been the subject of numerous investigations since its development and initial use. While the prepartum period was previously investigated with this tool [25], no validation study has focused on postpartum women. Several French studies used MSPSS translations during postpartum period without references of psychometric properties [2, 31–34]. In comparison with existing social support scales, the MSPSS is a very short scale that is well accepted by participants, particularly by new mothers. A French validation of MSPSS could be useful, as a complement to existing blues symptoms scales, for identifying French-speaking women at risk in the immediate postpartum. This internationally well accepted tool could be very useful both for clinical and research fields. Moreover, the results could also complete works about cross-cultural validity of MSPSS.
Methodology Participants Women who participated in the study were solicited during their stay in a French university maternity service, in the South of France. Two days postpartum, participants completed a protocol composed of basic demographic information and accepted to be contacted again by mail at 1 month (time 1) and at 4 months (time 2) postpartum to complete the French version of the MSPSS and a scale
123
Table 1 Socio-biographical and gynecological characteristics of the sample (N = 148) Variables
N = 148 n (%)
Professional activity
121 (81.76)
Partnership status Celibate As a couple, with the baby’s father
3 (2.03) 145 (97.97)
Primiparity
87 (58.78)
Hospitalizations during pregnancy
32 (21.62)
Lenght of pregnancy Less than 36 weeks
22 (14.86)
More than 36 weeks
126 (85.14)
Type of delivery Vaginal
95 (64.19)
Vaginal with instruments
22 (14.86)
Cesarean
31 (20.94)
Type of anesthesia None
21 (14.19)
Epidural
124 (83.78)
General
3 (2.03)
Gender of the baby Male
77 (52.03)
Female
71 (47.97)
assessing depressive postnatal symptoms (EPDS). Among the 210 women asked to participate, 36 refused participation based on the longitudinal protocol (commitment seen as being too constraining) and 26 participants had to be removed from the sample because they did not complete the questionnaires at time 2. At 1 month postpartum (time 1), no significant difference was found on the EPDS (z = 0.28; p = 0.77) and the MSPSS scores (z = -0.15; p = 0.87) between the women who didn’t complete questionnaires at time 2 and the other women. The final sample consisted of 148 women aged 30.5 years on average (SD = 5.12; min = 20, max = 45). Socio-biographical and gynaecological characteristics of the sample are presented in Table 1. All women were contacted on the maternity ward by the first author of the study and signed a consent form agreeing to participate (Anne Denis, psychologist). The study was developed in coordination with the hospital; approval for this non-intervention-based-research was provided by the local institutional board. The research fulfilled the national laws regarding ethics and research. Measuring Instruments The Multidimensional Scale of Perceived Social Support (MSPSS; Zimet et al. [12]) is a self-administered
Matern Child Health J
questionnaire consisting of 12 items that assess perceived social support from three sources: the family (FAM) (for example item 3: ‘‘My family really tries to help me’’), friends (FRI) (for example item 7 ‘‘I can count on my friends when things go wrong’’) and significant others (SO) (for example item 10 ‘‘There is a special person in my life who cares about my feelings’’). Participants indicate their level of agreement or disagreement with the items using a seven-point Likert scale ranging from 1 (completely disagree) to 7 (strongly agree). Each of the three dimensions (FAM, FRI, SO) has four items and sub-dimensional scores vary from 4 to 28 points. A high score on each of these subdimensions indicates high perceived social support. The Edinburgh Post-Natal Depression Scale (EPDS) is a self-administered questionnaire identifying postnatal depression symptoms using 10 Likert-type items (for example, item 1, ‘‘In the past 7 days, I have been able to laugh and see the funny side of things: As much as I always could (0); Not quite so much now (1); Definitely less than I used to (2); Hardly at all (3)’’). The range of possible scores varies from 0 to 30. Developed by Cox et al. [35], the EPDS has been validated in French by Guedeney and Fermanian in 1998 [36]. The threshold commonly used for indicating the presence of postnatal depression is 12 [3]. The internal consistency of the EPDS is in the current study was quite satisfactory (a = 0.87). Translation Procedure A parallel back-translation procedure was used to adapt the MSPSS in French. A first translation from English to French was established by a French person (AD, university student). A second person, native English speaker (SC, university professor) translated the French translation without referring to the original version (blind back translation). Finally, the two versions in English (original version and version obtained by back-translation) were compared and studied by the authors to ensure the absence of inaccuracy. A final reading of the items was made by French scholars to make the final corrections. The final version is presented in ‘‘Appendix’’.
and (e) the Standardized Root Mean Square Residual (SRMR) (standard: \0.08) [38]. Finally, the fidelity of the instrument was tested using Cronbach’s alpha, Pearson’s correlations and Repeated Measures t tests. The results were analysed using SPSS Amos, Version 20.
Results Homogeneity of the Sample Because the sample included women with different sociobiographical and gynecological characteristics, Chi-square tests were conducted to confirm the homogeneity of the sample. No significant differences were found with regard to marital status (Chi-square = 23.79; p = 0.97), primiparity (v2 = 41.89; p = 0.35), preterm birth (v2 = 27.29; p = 0.92) or hospitalization during pregnancy (v2 = 44.6; p = 0.25). Confirmatory Factor Analysis A confirmatory factor analysis was performed on the data observed at 1 month postpartum (T1) to test the three factor structure proposed by Zimet et al. [25] and confirmed by six recent studies [16, 17, 19, 22, 24, 29]. Despite AGFI (0.8) and Chi-2/ddl (144.36/51 = 2.83) values slightly lower than usually found in the literature, the results remain satisfactory (CFI = 0.95; RMSEA = 0.08; SRMR = 0.04). Internal Consistency The internal consistency of the French version is quite satisfactory both in terms of total questionnaire (a = 0.92) as well as for each of the three sub-dimensions (a = 0.94 for the FAM dimension; a = 0.91 for the FRI dimension and a = 0.92 for the SO dimension). Correlation Analysis at Time 1 and Test–Retest Reliability
Statistical Analysis The homogeneity of the sample was tested using Chi-square tests. A confirmatory factor analysis was performed to test the original three factor model of the MSPSS. The fit indices used to evaluate the overall model were (a) the Chisquare model divided by the degree of freedom (Chi-2/ddl) (standard:\2) [37], (b) the Adjusted Goodness of Fit Index (AGFI) (standard:[0.9) [37], (c) the Comparative Fit Index (CFI) (standard: C0.95) [38], (d) the Root Mean Square Error of approximation (RMSEA) (standard: B0.08) [39]
Descriptive statistics and correlation analysis were performed on the total score of the MSPSS and each subscores observed in MSPSS at time 1 (Table 2). The total MSPSS score is positively correlated with each of the three sub-dimensions of MSPSS. The mean EPDS score was 8.22 (SD = 5.64). Thirtyseven women (25 %) had scores equal or superior to 12, which as noted above is an indicator of postnatal depression [3]. A significant negative correlation was noted between MSPSS and the postpartum depression symptoms
123
Matern Child Health J Table 2 Descriptive statistics of the Multidimensional Scale of Perceived Social Support (MSPSS) and correlations between the MSPSS and the Edinburgh Postnatal Depression Scale (EPDS) obtained 1 month post-partum (N = 148) Variable
M
SD
Correlations MSPSS total
MSPSS total
68.82
Friends
Significant other
13.22
Family
22.06
6.27
0.85*
Friends Significant Other
22.13 24.7
5.03 4.79
0.77* 0.84*
8.22
5.64
-0.17*
EPDS
Family
0.42* 0.58* -0.12
0.53* -0.18*
-0.11
MSPSS Multidimensional Scale of Perceived Social Support, EPDS Edinburgh Postnatal Depression Scale * Correlation significant at p \ 0.05
Table 3 Correlations between the total score and the sub-scores of the Multidimensional Scale of Perceived Social Support (MSPSS) obtained 1 month post-partum (T1) and 4 months post-partum (T2) (N = 148)
MSPSS total (T2)
MSPSS total (T1)
Family (T1)
Friends (T1)
SO (T1)
0.55*
0.52*
0.4*
0.41*
Family
0.46*
0.68*
0.14*
0.24*
Friends
0.46*
0.23*
0.61*
0.33*
SO
0.35*
0.25*
0.21*
0.43*
MSPSS Multidimensional Scale of Perceived Social Support, SO significant other * Correlation significant at p \ 0.05
Table 4 Comparison of the average scores obtained on the Multidimensional Scale of Perceived Social Support (MSPSS) 1 month post-partum (T1) and 4 months post-partum (T2) (N = 148) T1
MSPSS total
T2
M
SD
M
SD
69.26
t(147)
p
68.82
13.22
12.85
-0.43
0.67
Family
22.06
6.27
22
6.38
0.15
0.88
Friends SO
22.13 24.69
5.03 4.79
22.01 25.26
5.33 4.53
0.3 -1.38
0.76 0.17
MSPSS Multidimensional Scale of Perceived Social Support, SO significant other
scale (r = -0.17). Regarding the sub-dimensions, only the FRI sub-dimension was correlated with the level of postpartum depression symptoms (r = -0.18). Analyses of correlations were made between the total MSPSS scores and subscales scores obtained at 1 month (T1) and at 4 months postpartum (T2). All correlations were significantly positive (Table 3). No significant difference was observed between the average MSPSS score obtained at time 1 and the average score obtained at time 2 (Table 4). Table 5 presents the factor loadings for all the items at the two time points.
123
Discussion The results of this study suggest that the French version of the MSPSS can be considered to be a reliable and valid instrument for measuring perceived social support among young French mothers. The hypothesis for a three-factor structure was confirmed in this French sample. Concerning the principal gynaecological characteristics of the mothers, the proportion of delivery mode (79 % vaginal delivery; 21 % caesarean sections) as well as use of epidural anaesthesia were similar to results from another French study [2]. Concerning postnatal depression symptoms, the observed rate was in keeping with previous studies as mentioned by Gaillard et al. [3]. These results suggest good representativeness of the sample. Regarding the confirmatory factor analysis of the French version, three of the indicators calculated suggest a good model fit. The CFI (0.95) was acceptable according to the standard recommended by Hu and Bentler (C0.95) [38] and was comparable to those found in all six confirmatory studies [16, 17, 19, 22, 24, 29]. The RMSEA (0.08) was also acceptable according to MacCallum et al.’s criteria (standard: B0.08) [39]. While two studies reported a RMSEA slightly lower than the one found in our sample [22, 29], this result is comparable to the work of Duru [19], Clara et al. [17] and Vaingankar et al. [24]. Finally, concerning the SRMR (0.04), this index was indicated only in the studies by Duru [19] and Cheng and Chan [16]. It was comparable to the one reported in these two studies and is acceptable according to the criteria proposed by Hu and Bentler (standard: \0.08) [38]. Two indices, however, were slightly outside the recommended standards. The AGFI index in the current (AGFI = 0.8) was lower than the standard recommended by Tabachnick and Fidell ([0.9) [37]. Of the six confirmation studies on the MSPSS, only three studies reported the AGFI index. While the AGFI calculated in this study is comparable to the one found in the clinical sample of Clara et al. [17], it is less optimal than the one found by
Matern Child Health J Table 5 Means (M), standard deviations (SD), item-total correlations (r), and factor loadings of MSPSS items 1 month post-partum (Time 1) and 4 months post-partum (Time 2) (N = 148) Items
M
SD
r
F1
F2
F3
There is a special person who is around when I am in need
6.07
1.4
0.73
0.24
0.21
0.82*
There is a special person with whom I can share my joys and sorrows
6.14
1.33
0.77
0.24
0.26
0.84*
My family really tries to help me
5.64
1.63
0.8
0.86*
0.14
0.32
I get the emotional help and support I need from my family
5.47
1.65
0.81
0.89*
0.14
0.30
I have a special person who is a real source of comfort to me
6.16
1.32
0.78
0.27
0.29
0.80*
My friends really try to help me I can count on my friends when things go wrong
5.26 5.48
1.36 1.44
0.64 0.68
0.14 0.15
0.78* 0.86*
0.21 0.18
Time 1
I can talk about my problems with my family
5.62
1.63
0.81
0.86*
0.31
0.18
I have friends with whom I can share my joys and sorrows
5.69
1.38
0.72
0.15
0.86*
0.25
There is a special person in my life who cares about my feelings
6.3
1.26
0.73
0.27
0.17
0.83*
My family is willing to help me make decisions
5.31
1.81
0.74
0.87*
0.13
0.21
I can talk about my problems with my friends
5.64
1.42
0.72
0.19
0.88*
0.20
There is a special person who is around when I am in need
6.32
1.25
0.76
0.21
0.25
0.87*
There is a special person with whom I can share my joys and sorrows
6.29
1.24
0.77
0.30
0.21
0.85*
My family really tries to help me
5.66
1.63
0.73
0.07
0.91*
0.21
I get the emotional help and support I need from my family
5.45
1.7
0.78
0.15
0.92*
0.21
I have a special person who is a real source of comfort to me
6.28
1.29
0.74
0.23
0.19
0.88*
My friends really try to help me
5.35
1.32
0.69
0.83*
0.20
0.18
Time 2
I can count on my friends when things go wrong
5.42
1.48
0.71
0.91*
0.11
0.22
I can talk about my problems with my family I have friends with whom I can share my joys and sorrows
5.47 5.64
1.69 1.47
0.76 0.71
0.25 0.88*
0.88* 0.06
0.12 0.31
There is a special person in my life who cares about my feelings
6.35
1.18
0.63
0.16
0.17
0.79*
My family is willing to help me make decisions
5.4
1.77
0.74
0.09
0.88*
0.25
I can talk about my problems with my friends
5.56
1.47
0.72
0.89*
0.18
0.18
N = 148. Salient factor loadings ([0.4) are flagged (*)
Vaingankar et al. (0.91) [24] and Bruwer et al. [29]. The comparison with these two models, however, is problematic because of differing samples. While the current study focuses on post-partum mothers, the Vaingankar et al. study [24] was conducted among patients with schizophrenia and the Bruwer et al. study [29] carried out on adolescents aged from 11.3 to 23.5 years. Regarding the Chi-square model divided by the degree of freedom, Tabachnick and Fidell [37] recommend a threshold less than or equal to 2 to determine good fit. As is the case in the current study, most confirmatory studies report higher values: 2.66 for Aroian et al. [22]; 3.79 for Clara et al. [17] in a clinical sample; 4.5 Duru [19]; 10,69 Cheng and Chan [16]; and the index was not reported in the studies by Bruwer et al. [29] and Vaingankar et al. [24]. Cronbach alphas for the full scale and for each subdimension (all a [ 0.9) confirm the apparently good internal consistency of the French version of the MSPSS. These coefficients are quite similar to those of the original
version [25]: a = 0.92 for the total scale and, respectively, 0.9, 0.94 and 0.9 for the FAM, FRI and SO dimensions. Concerning test–retest results, if all the correlations between the two measurement times are significantly positive, it should to be noted that these correlations are too weak to confirm the stability of the tool at 12 weeks (r = 0.54 for total score and r = 0.68, r = 0.61, r = 0.43 respectively for the FAM, FRI and SO dimensions). After verification, no significant difference was found between time 1 and time 2 scores. It is possible that this result is due to the specific context of post-partum. Indeed, 1 month after delivery, mothers were still on maternity leave whereas, 4 months after giving birth, most of them had returned to work. This contextual difference along with the novelty of being a mother could have had an impact on the results. Spiteri and Borg Xuereb [40] noted that women suffered from lack of received social support at their place of work. These women recognized that this transition affected their overall health.
123
Matern Child Health J
Finally, the divergent validity of the MSPSS is confirmed by a low and significant negative correlation found between depressive postpartum symptoms and perceived social support. As the literature shows, the feeling of lack of perceived social support is linked to postnatal depression symptomatology [10, 11, 41]. An analysis of the dimensions suggests that the lack of perceived social support from friends is most closely linked to postnatal depression symptoms (the only dimension for which a correlation was found). Some studies report that women generally perceive more support from their friends and from a significant other than from their families [12]. Future research should be undertaken in order to better evaluate the perceived influence of different sources of social support during the postpartum period. The French version of the MSPSS should also be tested in other samples with differing characteristics. In conclusion, the MSPSS is a quickly implemented and internationally well-accepted tool. The French version can provide a specific indicator for French-speaking women of perceived social support that can be used in research and in applied clinical settings during the postpartum period. Moreover, the confirmation of a three-factor structure for the French tool could suggest, in addition of several foreign language versions, the cross-cultural validity of MSPSS.
Appendix See Table 6.
Table 6 French translation of the Multidimensional Scale of Perceived Social Support 1. Il y a une personne en particulier qui est la` quand j’en ai besoin (APS) 2. Il y a une personne en particulier avec laquelle je peux partager mes joies et mes peines (APS) 3. Ma famille essaie vraiment de m’aider (F) 4. Je rec¸ois de ma famille toute l’aide e´motionnelle et le soutien dont j’ai besoin (F) 5. Je connais une personne en particulier qui est une vraie source de re´confort pour moi (APS) 6. Mes amis essaient vraiment de m’aider (A) 7. Je peux compter sur mes amis quand les choses vont mal (A) 8. Je peux parler de mes proble`mes avec ma famille (F) 9. J’ai des amis avec lesquels je peux partager mes joies et mes peines (A) 10. Il y a quelqu’un de spe´cial dans ma vie qui s’inquie`te de ce que je ressens (APS) 11. Ma famille est preˆte a` m’aider a` prendre des de´cisions (F) 12. Je peux parler de mes proble`mes avec mes amis (A) APS autre personne significative, F famille, A amis
123
References 1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder—4th edition revised (DSM-IVR). Washington, DC: APA. 2. Denis, A., Parant, O., & Callahan, S. (2011). Frequency of and risk factors for post-traumatic stress disorder related to birth: A prospective longitudinal study in a French population. Journal of Reproductive and Infant Psychology, 29(2), 125–135. 3. Gaillard, A., Le Strat, Y., Mandelbrot, L., Keita, H., & Dubertret, C. (2014). Predictors of postpartum depression: Prospective study of 264 women followed during pregnancy and postpartum. Psychiatry Research, 215(2), 341–346. 4. Kleiman, E. M., & Riskind, J. H. (2013). Utilized social support and self-esteem mediate the relationship between perceived social support and suicide ideation. A test of a multiple mediator model. Crisis, 34(1), 42–49. 5. Stein, A., Cooper, P. J., Campbell, E. A., Day, A., & Altman, P. E. A. (1989). Social adversity and perinatal complications: Their relation to postnatal depression. British Medical Journal, 298, 1073–1074. 6. O’Hara, M. W. (1986). Social support, life events and depression during pregnancy and the puerperium. Archive of General Psychiatry, 43, 569–573. 7. Se´journe´, N., Beaume´, M., Vaslot, V., & Chabrol, H. (2012). Effets du conge´ de paternite´ sur la de´pression du post-partum maternelle. Gyne´cologie Obste´trique et Fertilite´, 40, 360–364. 8. Husain, N., Cruickshank, K., Husain, M., Khan, S., Tomenson, B., & Rahman, A. (2012). Social stress and depression during pregnancy and in the postnatal period in British Pakistani mothers: A cohort study. Journal of Affective Disorders, 140, 268–276. 9. Lemola, S., Stadlmayr, W., & Grob, A. (2007). Maternal adjustment five months after birth: The impact of the subjective experience of childbirth and emotional support from the partner. Journal of Reproductive and Infant Psychology, 25(3), 190–202. 10. Ege, E., Timur, S., Zincir, H., Geckil, E., & Sunar-Reeder, B. (2008). Social support and symptoms of postpartum depression among new mothers in Eastern Turkey. Journal of Obstetrics and Gynaecology Research, 34(4), 585–593. 11. Yagmur, Y., & Ulukoca, N. (2010). Social support and postpartum depression in low-socioeconomic level postpartum women in Eastern Turkey. International Journal of Public Health, 55(6), 543–549. 12. Zimet, G. D., Dalhem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30–41. 13. Canty-Mitchell, J., & Zimet, G. D. (2000). Psychometric properties of the Multidimensional Scale of Perceived Social Support in urban adolescents. American Journal of Community Psychology, 28, 391–400. 14. Edwards, L. M. (2004). Measuring perceived social support in Mexican American youth: Psychometric properties of the Multidimensional Scale of Perceived Social Support. Hispanic Journal of Behavioral Sciences, 26, 187–194. 15. Ramaswamy, V., Aroian, K. J., & Templin, T. N. (2009). Adaptation and psychometric evaluation of the Multidimensional Scale of Perceived Social Support for Arab American Adolescents. American Journal of Community Psychology, 43, 49–56. 16. Cheng, S. T., & Chan, A. C. M. (2004). The multidimensional scale of perceived social support: Dimensionality and age and gender differences in adolescents. Personality and Individual Differences, 37(7), 1359–1369. 17. Clara, I. P., Cox, B., Murray, W. E., Murray, L. T., & Torgrudc, L. J. (2003). Confirmatory factor analysis of the Multidimensional Scale of Perceived Social Support in clinically distressed
Matern Child Health J
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
and student samples. Journal of Personality Assessment, 81(3), 265–270. Dahlem, N. W., Zimet, G. D., & Walker, R. R. (1991). The Multidimensional Scale of Perceived Social Support: A confirmation study. Journal of Clinical Psychology, 47, 756–761. Duru, E. (2007). Re-examination of the psychometric characteristics of the multidimensional scale of perceived social support among Turkish university students. Social Behavior and Personnality, 35(4), 443–452. Eker, D., & Arkar, H. (1995). Perceived social support: Psychometric properties of the MSPSS in normal and pathological groups in a developing country. Social Psychiatry and Psychiatric Epidemiology, 30, 121–126. Kasarian, S. S., & McCabe, S. B. (1991). Dimensions of social support in the MSPSS: Factorial structure, reliability, and theoretical implications. Journal of Community Psychology, 19, 150–160. Aroian, K., Templin, T. N., & Ramaswamy, V. (2010). Adaptation and psychometric evaluation of the Multidimensional Scale of Perceived Social Support for Arab immigrant women. Health Care for Women International, 31, 153–169. Cecil, H., Stanley, M. A., Carrion, P. G., & Swann, A. (1995). Psychometric properties of the MSPSS and NOS in psychiatric outpatients. Journal of Clinical Psychology, 51, 593–602. Vaingankar, J. A., Abdin, E., & Chong, S. A. (2012). Exploratory and confirmatory factor analyses of the Multidimensional Scale of Perceived Social Support in patients with schizophrenia. Comprehensive Psychiatry, 53, 286–291. Zimet, G. D., Powel, S. S., Farley, G. K., Werkman, S., & Berkoff, K. A. (1990). Psychometric characte´ristics of the Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 55(3&4), 610–617. Stanley, M. A., Beck, J. G., & Zebb, B. J. (1998). Psychometric properties of the MSPSS in older adults. Aging and Mental Health, 2, 186–193. Chou, K. L. (2000). Assessing Chinese adolescents’ social support: The Multidimensional Scale of Perceived Social Support. Personality and Individual Differences, 28(2), 299–307. Ng, C. G., Amer Siddiq, A. N., Aida, S. A., Zainal, N. Z., & Koh, O. H. (2010). Validation of the Malay version of the Multidimensional Scale of Perceived Social Support (MSPSS-M) among a group of medical students in Faculty of medicine. Asian Journal of Psychiatry, 3(1), 3–6. Bruwer, B., Emsley, R., Kidd, M., Lochner, C., & Seedat, S. (2008). Psychometric properties of the Multidimensional Scale of
30.
31.
32. 33.
34.
35.
36.
37. 38.
39.
40.
41.
Perceived Social Support in youth. Comprehensive Psychiatry, 49(2), 195–201. Prezza, M., & Pacilli, M. G. (2002). Perceived social support from significant others, family and friends and several sociodemographic characteristics. Journal of Community and Applied Social Psychology, 12, 422–429. Callahan, S., & Denis, A. (2013). Irrational beliefs and motherhood: ‘‘Hot cognitions’’ and their relationship to perinatal psychopathology. Journal de The´rapie Comportementale et Cognitive, 23(1), 3–8. Minnes, S., Singer, L. T., Humphrey-Wall, R., & Satayathum, S. (2008). Child Abuse and Neglect, 32(3), 353–366. Se´journe´, N., Beaume, M., Vaslot, V., & Chabrol, H. (2012). Effets du conge´ de paternite´ sur la de´pression du post-partum maternelle. Gyne´cologie Obste´trique & Fertilite´, 40(6), 360–364. Se´journe´, N., Vaslot, V., Beame´, M., Goutaudier, N., & Chabrol, H. (2012). The impact of paternity leave and paternal involvement in child care on maternal postpartum depression. Journal of Reproductive and Infant Psychology, 30(2), 135–144. Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. Guedeney, N., & Fermanian, J. (1998). Validation study of the French version of the Edinburgh Post-Natal Depression Scale (EPDS): New results about use and psychometric properties. European Psychiatry, 13, 83–89. Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). New York: Allyn and Bacon. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis. Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. MacCallum, R. C., Browne, M. W., & Sugawara, H. M. (1996). Power analysis and determination of sample size for covariance structure modeling. Psychological Methods, 1(2), 130–149. Spiteri, G., & Borg Xuereb, R. (2012). Going back to work after childbirth: Women’s lived experiences. Journal of Reproductive and Infant Psychology, 30(2), 201–216. Guedeney, N., Jacquemain, F., & Glangeaud-Freudenthal, M.-C. (2000). Le roˆle des facteurs environnementaux, de la vulne´rabilite´ individuelle et du support social dans le risque de survenue des de´pressions du post-partum. Devenir, 12, 13–33.
123
