Open Access Research article

Development of the Tilburg Pregnancy Distress Scale: the TPDS

Victor JM Pop1*, Antoinette M Pommer1, Monica Pop-Purceleanu2, Hennie AA Wijnen3, Veerle Bergink4 and Frans Pouwer1

Author affiliations

1 Department of Medical Health Psychology, University of Tilburg, (Warandelaan), Tilburg, (Postbus 90153), The Netherlands

2 Department of Psychiatry, Nijmegen MC, University Medical Centre, (Geert Grooteplein - Zuid), Nijmegen,(Postbus 9101), the Netherlands

3 Department of Midwifery Science, AVM University, (Universiteitssingel), Maastricht, (Postbus 1256), the Netherlands

4 Department of Psychiatry, Erasmus MC, University Medical Centre, ('s - Gravendijkwal), Rotterdam, (Postbus 2040), The Netherlands

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Citation and License

BMC Pregnancy and Childbirth 2011, 11:80  doi:10.1186/1471-2393-11-80

Published: 26 October 2011



Pregnant women with high levels of stress, depression and/or anxiety are at increased risk for adverse perinatal outcomes and impaired neurologic and emotional development of the offspring. Pregnancy specific instruments to measure psychological functioning during gestation are scarce and do not define items based on in-depth interviews of pregnant and recently delivered women. The current study developed a pregnancy specific scale that measures psychological functioning using in-depth interviews.


Three focus groups were formed to discuss issues most relevant to pregnancy distress; 22 candidate items were derived for pilot testing (study I, n = 419) its psychometric properties by means of explorative factor analyses (EFA). This resulted in a 17-item TPDS which was further explored by confirmatory factor analyses (CFA) and concurrent and construct validity assessment (study II, n = 454).


EFA in study I suggested a two component solution (negative affect (NA) and partner involvement (PI)). CFA in study II resulted in a higher order model of the NA subscale into three more subscales: NA regarding confinement, delivery and general health. TPDS, EPDS and GAD-7 were all significantly correlated.


The TPDS constitutes a valid and user friendly instrument to assess pregnancy distress. In addition to its proven ability to pick up pregnancy specific negative affect it also includes an important sub-scale measuring perceived partner involvement.