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Publication Date: 
October, 2009
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Research studies on post-partum PTSD have highlighted that the experience of childbirth can be traumatic in itself because it often involves fear, pain, impotence and non-expressed negative emotions. This study hypothesized that mental processing post-partum emotions, through Pennekaber?s expressive writing (EW) method, can reduce short- and long-term posttraumatic symptoms. The sample was of 242 women (mean age=31.5; SD=4) of whom 120 performed the EW-task and 122 were not asked to write. The Perinatal PTSD Questionnaire (PPQ) was administered 48 hours and two months after childbirth (the total sample) and 12 months after childbirth (65 women). The data show a positive effect of expressive writing, which allows them to process and mentalize negative emotions, worries and fears, deactivating both avoidance mechanisms and physiological symptoms linked to hyperarousal.


Abramowitz, J. S., Schwartz, S. A., Moore, K M., & Luenzmann, K R. (2003). Obsessive-compulsive symptoms in pregnancy and the puerperium: A review of the literature. Journal of Anxiety Disorders, 17, 461-478.

Affleck, G., Tennen, H., & Rowe, J. (1991). Infant in crisis: how parents cope with newborn intensive care and its aftermath. New York: Springer-Verlag.

American Psychiatric Association (2000). Diagnostic and Statistical Manual-Text Revision (4th ed.; DSM-IV TR). Washington, DC: Author.

Ayers, S. (2004). Delivery as a traumatic event: Prevalence, risk factors, screening & treatment for postnatal posttraumatic stress. Clinical Obstetrics & Gynecology, 47(3), 552-567.

Ayers, S., & Pickering, A. D. (2001). Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth, 28(2), 111-118.

Ballard, C. G., Stanley, A. K, & Brockington, I. E (1995). Post Traumatic Stress Disorder (PTSD) after childbirth. British Journal of Psychiatry, 166, 525-528.

Beck, A. T, Emery, G. A., & Greenberg, R L. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.

Beck, C. T. (2004). Birth trauma: In the eye of the beholder. Nursing Researches, 53, 28-35.

Briere, J., Weathers, E, & Runtz, M (2005). Is dissociation a multidimensional construct? Data from the Multiscale Dissociation Inventory. Journal of Traumatic Stress, 18(3), 221-231.

Bydlowsky, M., & Raul-Duval, A. (1978). Un avatar psychique méconnu de la puepéralité: La névrose traumatic post-obstétricale. Perspectives Psychiatriques, 4, 321-8.

Creedy, D. K. (1999). Postnatal depression and posttraumatic stress disorder: What are the links? Birth, 8, 125-130.

Greedy, D. K, Shochet, I. M., & Horsfall, J. (2000). Childbirth and the development of acute trauma symptoms: Incidence and contributing factors. Birth, 27(2), 104-111.

Czarnocka, J., & Slade, P. (2000). Prevalence and predictors of post-traumatic stress symptoms following childbirth. British Journal of Clinical Psychology, 39, 35-41.

DeMier, R. L., Hynan, M. T, Harris, H. B., & MannieUo, R. L. (1996). Perinatal Stressors as predictors of symptoms of posttraumatic stress in mother and infants at high-risk. Journal of Perinatology, 16, 276-280.

Di Blasio, P. & Ionio, C. (2002). Childbirth and narratives: How do mothers deal with their childbirth? Journal of Prenatal and Perinatal Psychology and Health, 17(2), 143-151.

Di Blasio, P. & Ionio, C. (2005). Postpartum stress symptoms and child temperament: A follow-up study. Journal of Prenatal and Perinatal Psychology and Health, 19(3), 185-198.

Fones, C. (1996). Posttraumatic stress disorder occurring after painful childbirth. Journal of Nervous and Mental Disease, 184, 195-196.

Harlbreich, U. (2005). The association between pregnancy processes, prêterai delivery, low birth weight and post partum depression. The need for interdisciplinary integration. American Journal of Obstetric and Gynecologic, 193, 1312-1322.

Hathaway, S. R., & McKinley, J. C. (1995). MMPI-2. Minnesota Multiphasic Personality Inventory-2. Firenze: OS. (Original work published 1989)

Hynan, M. T. (1998). The perinatal posttraumatic stress disorder (PTSD) questionnaire (PPQ). In R. Wood & C. P. Zalaquette (Eds.), Evaluating stress: A handbook of resources (vol. 2). London: The Scarecrow Press, Inc.

Lepore, S. (1997). Expressive writing moderates the relation between intrusive thoughts and depressive symptoms. Journal of Personality and Social Psychology, 73, 1030-1037.

Matthey, S., Barnett, B., Howie, P., & Kavanagh, D. J. (2003). Diagnosing postpartum depression in mothers and fathers: Whatever happened to anxiety? Journal of Affective Disorders, 74, 139-147.

McMahon, C., Barnett, B., Kowalenko, N., & Tennant, C. (2001). Postnatal depression, anxiety and unsettled infant behavior. Australian and New Zealand Journal of Psychiatry, 35, 581-588.

Menage, J. (1993). Posttraumatic stress disorders in women who have undergone obstetric and or gynecological procedures: A consecutive series of 30 cases of PTSD. Journal of Reproductive and Infant Psychology, 11, 221-228.

Pancheri, P., & Sirigatti, S. (1995). Minnesota Multiphasic Personality Inventory - 2. Firenze: OS.

Pennebaker, J. W. (1985). Traumatic experience and psychosomatic disease: Exploring the roles of behavior, obsession and confiding. Canadian Psychology, 26, 82-95.

Pennebaker, J. W. (1999). Tradurre in parole le esperienze traumatiche: Implicazioni per l'abuso infantile e per il mantenimento della salute. Psicologia della salute, 2, 32-48.

Pennebaker, J. W., & Beali, S. K. (1986). Confronting a traumatic event: Toward and understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274-281.

Pennebaker, J. W., Kielcolt-Glaser, J. K., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implication for psychotherapy. Journal of Consulting and Clinical Psychology, 64, 239-245.

Quinnel, F. A., & Hynan, M. T. (1999). Convergent and discriminant validity of perinatal PTSD questionnaire (PPQ). Journal of Traumatic Stress, 72(1), 193-199.

Shear, M. K., & Mammen, O. (1995). Anxiety disorders in pregnant and postpartum women. Psychopharmacology Bulletin, 31, 693-703.

Soet, J. E., Brack, G. A., & Dilorio, C. (2003). Prevalence and predictors of women's experience of psychological trauma during childbirth. Birth, 30, 36-46.

van Son, M., Verkerk, G., van der Hart, O., Komproe, L, & Pop, V. (2005). Prenatal depression, mode of delivery and perinatal dissociation as predictors of postpartum posttraumatie stress: An empirical study. Clinical Psychology and Psychotherapy, 72,297-312.

Wegner, D., Schneider, D., Carter, S., & White, T. (1987). Paradoxical aspects of thought suppression. Journal of Personality and Social Psychology, 53, 5-13.

Wenzel, A., Haugen, E. N., Jackson, L. C., & Brendle, J. R. (2005). Anxiety symptoms and disorders at eight weeks postpartum. Journal of Anxiety Disorders, 19, 295-311.

White, T., Matthey, S., Boyd, K, & Barnett, B. (2006). Postnatal depression and post-traumatic stress after childbirth: Prevalence, course and co-occurrence. Journal of Reproductive and Infant Psychology, 24(2), 107 - 120.

Wijma, K., Wijma, B., & Soderquist, M. A. (1997). Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. Journal of Psychosomatic Obstetric and Gynecologic, 77(6), 587-597.

Wijma, K., Wijma, B., & Zar, M. (1998). Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. Journal of Psychosomatic Obstetric and Gynecologic, 19, 84-97.