Measuring postnatal demoralisation: adaptation of the Demoralisation Scale-II (DS-II) for postnatal use

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Objective: To examine the psychometric properties of the Demoralisation Scale II (DS-II) and adapt it for use with women in the postnatal period. Background: Demoralisation is a psychological state characterised by a sense of incompetence and feelings of helplessness and hopelessness in response to a stressful situation. The postnatal period is a life stage of many disruptions. Women may lose their confidence and become demoralised if feeling unprepared for the tasks of motherhood. The DS-II is a 16-item scale developed among cancer patients, but with content that is also relevant postnatally, including items on sense of failure, helplessness, hopelessness, isolation, entrapment and loss of purpose. Methods: Rasch analysis was used to investigate the psychometric properties of the DS-II and refine the scale for postnatal use. Results: Participants were 209 women admitted with their babies to a residential early parenting programme. A 14-item revised scale was derived, the Postnatal DS-II, showing good psychometric properties, discriminant validity and sensitivity to change, and being well targeted to the sample. Conclusion: The Postnatal DS-II could have utility as an assessment tool, helping clinicians to understand better women’s postnatal experiences, assess the effectiveness of interventions and communicate with women in a meaningful and non-stigmatising way.

Original languageEnglish
Pages (from-to)561-577
Number of pages17
JournalJournal of Reproductive and Infant Psychology
Issue number5
Publication statusPublished - 20 Oct 2018


  • Demoralisation
  • mental health
  • parenting
  • postpartum period
  • psychometrics
  • women

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