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Hispanics, instrument, postpartum depression, screening



  1. Beck, Cheryl Tatano
  2. Gable, Robert K.


Background: Postpartum depression is a global phenomenon.


Objective: The purpose of this study was to develop and psychometrically evaluate the Spanish version of the Postpartum Depression Screening Scale (PDSS).


Methods: Eight translators representing the predominant Hispanic groups in the United States translated the PDSS into a Spanish version. A total of 377 Hispanic mothers completed the PDSS-Spanish Version within 12 weeks postpartum at two sites: Connecticut and Texas. Confirmatory factor analysis and item response theory analysis were conducted to assess construct validity.


Results: For the total sample of 377 Hispanic women, the alpha reliability for the total PDSS was .95; dimension-level alphas ranged from .76 to .90. The total PDSS alphas by group were as follows: .94 (Mexican), .96 (Puerto Rican), and .93 (Other). Confirmatory factor analysis provided empirical support for the existence of the hypothesized constructs assessed by the PDSS. Item response theory analysis supported the adequacy of the construct definitions and confirmed that the response options for the Likert categories were an "ordered" attitude continuum in which higher responses corresponded to higher levels of "agreement" with the depressive symptomatology items.


Conclusions: When compared to the original English PDSS, the reliability and validity psychometrics for the Spanish version were slightly lower, but still within the acceptable range.


Postpartum depression (PPD) is a global phenomenon. An international study exploring levels of postpartum depressive symptomatology among 892 women from nine countries that represented five continents, revealed that women from South America had one of the highest levels of depressive symptomatology (Affonso, De, Horowitz, & Mayberry, 2000). Prevalence rates of postpartum depression have been reported in Chile and Brazil as ranging from 10% (Jadresic, Araya, & Jara, 1995) and 12% (Da-Silva, Moraes-Santos, Carvalho, Martins, & Teixeira, 1998). These percentages are similar to the 13% prevalence rate reported in O'Hara and Swain's (1996) meta-analysis of 59 international studies.


PPD is covertly suffered; more than one-half of all cases remain undetected (Hearn et al., 1998). This emphasizes the critical need for routine use of screening scales to detect PPD in women from all cultures. PPD is one of the major factors affecting access to perinatal care for California/Mexico border-dwelling Hispanic women (Zaid, Fullerton, & Moore, 1996). Prompt accurate assessment is imperative. The steady rise of Hispanics living in the United States that occurred during the 20th century continues in the 21st century. The U.S. Census Bureau (2000) projects the Hispanic population in the United States to be 61,433,000 (18.2%) in 2025 and 98,229,000 (24.3%) in 2050.


The rising numbers of live births to Hispanic mothers over the last decade in the United States reflect the heterogeneous population. In 1989 there was a total of 532,249 live births recorded; by 1999 the total had increased to 764,339 (U.S. Census Bureau, 2001a). Examination of the 1999 statistics reveals: 70.7% of the live births to Hispanic mothers were Mexican, 13.5% Central and South American, 7.5% Puerto Rican, 1.7% Cuban, and 6.6% other Hispanic (U.S. Census Bureau, 2001b).


In their research agenda for Hispanics in the United States, Portillo et al. (2001) alerted nurse researchers to the severe limitations of existing Hispanic health data. Data on subgroup differences among Hispanics are sorely lacking. When conducting research with Hispanics, understanding disaggregated data is essential. In Healthy People 2010, the need for increased awareness of subgroup differences among Hispanics was also underscored (Department of Health & Human Services, 2001).


The purpose of this study was to develop and psychometrically evaluate a Spanish version of the Postpartum Depression Screening Scale (PDSS) (Beck & Gable, 2002). Data were collected and analyzed according to subgroup of origin. Because Spanish is the first language in several countries throughout the world, use of this translated scale can exceed the borders of the United States.