The Perinatal Anxiety Screening Scale: development and preliminary validation

Susanne Somerville, Kellie Dedman, Rosemary Hagan, Elizabeth Oxnam, Michelle Wettinger, Shannon Byrne, Soledad Coo, Dorota Doherty, Andrew C. Page

The purpose of this study is to develop a scale (Perinatal Anxiety Screening Scale, PASS) to screen for a broad range of problematic anxiety symptoms which is sensitive to how anxiety presents in perinatal women and is suitable to use in a variety of settings including antenatal clinics, inpatient and outpatient hospital and mental health treatment settings. Women who attended a tertiary obstetric hospital in the state of Western Australia antenatally or postpartum (n = 437) completed the PASS and other commonly used measures of depression and anxiety. Factor analysis was used to examine factor structure, and ROC analysis was used to evaluate performance as a screening tool. The PASS was significantly correlated with other measures of depression and anxiety. Principal component analyses (PCA) suggested a four-factor structure addressing symptoms of (1) acute anxiety and adjustment, (2) general worry and specific fears, (3) perfectionism, control and trauma and (4) social anxiety. The four subscales and total scale demonstrated high to excellent reliabilities. At the optimal cutoff score for detecting anxiety as determined by ROC analyses, the PASS identified 68 % of women with a diagnosed anxiety disorder. This was compared to the EPDS anxiety subscale which detected 36 % of anxiety disorders. The PASS is an acceptable, valid and useful screening tool for the identification of risk of significant anxiety in women in the perinatal period.