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Actually, every year in Greece, more than half of deliveries are cesarean deliveries deteriorating the problem.įurthermore, women who undergo CS are more likely to develop postpartum mental disorders and especially P-PTSD compared to women who undergo vaginal birth and, therefore, deserve a closer follow-up during the postpartum period. Given that CS is associated with P-PTSD, in Greek mothers the problem is greater due to the high prevalence of CS. The factors that can lead to P-PTSD are common in postpartum women of all countries. Other main risk factors for P-PTSD area history of previous mental disorder, preterm labor, inclusion of neonate in neonatal intensive care unit, lack of breastfeeding and a lack of support from spouse during the perinatal period. Many researchers also have identified the kind of delivery, and in particular cesarean delivery, as a major risk factor for the development of P-PTSD, with a great correlation of PTSD to emergency cesarean section (EMCS) and elective cesarean section (ELCS). Nevertheless, in recent year several studies have shown that childbirth can become a traumatic event about 1.5%-6% of mothers may develop Postpartum PTSD (P-PTSD). For several years a childbirth experience was viewed by scientists as a positive experience for women. The prevalence of PTSD is two times greater in women than in men it is influenced by hormonal disorders, stressful life events, such as sexual abuse and childbirth experiences. This subtype, in addition to meeting full PTSD criteria, captures persons who meet dissociative symptoms (depersonalization or derealization) and emotional detachment. Furthermore, a new dissociative subtype of PTSD was created. The continuing evolution of the field of symptomatology highlights that PTSD remains a complex disorder making accurate measurement of symptoms even more important. Several important revisions were made to the PCL in updating it for the DSM-5.Thus, according to the DSM-5, PTSD has been moved out of the anxiety disorders section and moved to a new category identified as “trauma and stressor-related disorders”. The PTSD was formally recognized in the Diagnostic and Statistical Manual 3 rd version (DSM-III) in 1980, but its diagnostic criteria have been repeatedly revised in the editions of the DSM. One of the most frequently used PTSD measure is the Posttraumatic Stress Disorder Checklist (PCL) which has recently undergone substantial revision in the 5 th Edition of Diagnostic and Statistical Manual (DSM-5), developed by Weathers et al, 2013. The most common PTSD symptoms are clustered into a four-dimensional structure: Intrusion/re-experiencing (Criterion B), avoidance (Criterion C), negative alterations in cognition and mood (Criterion D) and alteration in arousal and reactivity (Criterion E). The Posttraumatic Stress Disorder (PTSD) is a mental health problem that some people develop after experiencing or witnessing a life-threatening event like combat, disaster, assault or sexual violence (Criterion A). Overall, all the results suggest that the four-factor PCL-5 seemed to work adequately for the Greek sample of women after CS. Factor analyses demonstrated acceptable construct validity a comparison of thePCL-5 with the other measures of the same concept showed a good convergent validity of the scale. The data were positively skewed, suggesting that the reported levels of PTSD among our participants were low. To evaluate the internal reliability of the PCL-5 two different indices of internal consistency were calculated, i.e., Cronbach’s alpha (.97) and Guttman’ssplit-half (.95), demonstrating high reliability level. Measures used in this study were the PCL-5 for DSM-5, the Life Events Checklist (LEC-5), Criteria B, C, D, E, and Criterion A, specifically designed for detection of posttraumatic stress disorder (PTSD) symptoms in postpartum period.
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The participating women ( N = 469), who gave birth with emergency and elective CS at the Greek University Hospital of Larisa, have consented to participate in two phases of the survey and completed self-report questionnaires, the 2 nd day after CS and at the 6 th week after CS. The aim of this study was to examine psychometric properties of the revised Posttraumatic Stress Checklist (PCL-5) for Diagnostic and Statistical Manual– 5 th Edition (DSM-5) in Greek postpartum women after Cesarean Section(CS) (emergency-elective).So far, there was no study in Greece assessing psychometric properties of the PCL-5 in women after CS.