Patricia Lee King, a postdoctoral fellow at the USC School of Social Work, has published a literature review in the Journal of Health Care for the Poor and Underserved on the validity of postpartum depression screening across socioeconomic groups.
King evaluated how closely screening tools used to measure postpartum depression adhered to the standard definition of the disorder, as well as the potential bias that could be introduced by those tools when conducting studies with women of low socioeconomic status.
“Postpartum depression is a major public health social work challenge disproportionally impacting women with low socioeconomic status,” King said. “Yet our ability to identify women suffering from postpartum depression is impaired because we don’t know how postpartum depression screening tools work across socioeconomically diverse groups of women. Careful review of the existing literature on common screening tools will advance our screening practices and future research.”
She identified 20 research articles published between January 1980 and January 2010 that addressed the validity of four specific assessment tools: the Beck Depression Inventory, the Center for Epidemiological Studies Depression Scale, the Edinburgh Postnatal Depression Scale and the Postpartum Depression Screening Scale. Only eight of the articles explicitly included women of low socioeconomic status, and only three studies directly evaluated issues of validity.
King found that these screening tools lack the comprehensive evaluation and testing needed to support their use with socioeconomically diverse populations, which may result in missed opportunities to identify postpartum depression.
As a result of her findings, King recommended an alternate approach to screening for postpartum depression among all women that takes into account unique developmental and environmental contexts.