the Sierra Leone Perinatal Psychological Distress Scale (SLPPDS)

Description

The Sierra Leone Perinatal Psychological Distress Scale (SLPPDS; Bag et al., 2025) is designed to screen for perinatal psychological distress among women in Sierra Leone. The development of the SLPPDS involved several stages, beginning with the generation of a preliminary set of 31 items reflecting signs of distress. These items were developed with consideration of the unique needs, perspectives, and experiences of perinatal women in Sierra Leone. Cognitive interviews were conducted to refine the items. The items were then translated into Krio, a widely spoken language in Sierra Leone, and back-translated into English to ensure conceptual equivalence. The target population provided feedback to assess face validity, which is a crucial aspect of content validity. Following pilot testing, 25 items were retained. The SLPPDS was subsequently administered to a sample of pregnant women and new mothers residing in the Western Area and Bombali regions of Sierra Leone. A principal component analysis revealed one factor. An exploratory factor analysis with a varimax rotation for a 1-factor solution led to the elimination of 15 items. A confirmatory factor analysis supported a one-factor model, demonstrating an excellent fit to the data. Results concerning the internal consistency, convergent validity, discriminant validity, diagnostic validity, sensitivity and specificity were reported.

Purpose

The primary purpose of the SLPPDS is to screen for perinatal psychological distress, specifically addressing the unique needs, perspectives, and experiences of perinatal women in Sierra Leone.

Validity

The SLPPDS has undergone several assessments of its validity:

• Construct Validity: All items were found to load onto one factor, indicating that the scale has good construct validity.

• Content Validity: The target population judges helped in assessing face validity, a critical aspect of content validity.

• Convergent Validity: To evaluate the convergent validity, the relationship between the severity of psychological distress and the degree of dysfunction was examined. The consistent rise in psychological distress severity scores with each increase in dysfunction level provides additional evidence of the convergent validity of these measures.

• Discriminant Validity: The mean total symptom scores for the cases and non-cases on the SLPPDS were significantly different (P < .0001), with a mean of 13.6 points (SE 0.9) for cases and < 3.3 points (SE 0.9) for non-cases. This same pattern is held for the PHQ-9 scale scores as well.

• Diagnostic Validity: Sensitivity/specificity values for the SLPPDS were 80.0/85.7. ROC/cut-off points for SLPPDS were 0.90/0.81.

Reliability

• Internal Consistency: The Cronbach’s alpha was 0.883.

Factor Analysis

• Principal Component Analysis: One factor with an eigenvalue greater than 1.0 (Watkins, 2018) was retained. The principal axis factoring was used to examine the factor loading, which resulted in 54.9% of the variance explained by a 1-factor solution.

• Exploratory Factor Analysis: An exploratory factor analysis with a varimax rotation for a 1-factor solution resulted in the elimination of 15 items.

• Confirmatory Factor Analysis: The goodness-of-fit indices for the proposed model were: root mean square error of approximation (RMSEA) = 0.054, normal fit index (NFI) = 0.845, comparative fit index (CFI) = 0.952, and incremental fit index (IFI) = 0.955 (Tabachnick & Fidell, 2007).

Test Methodology

The development and validation of the SLPPDS involved several test methodologies, including:

• Test Validity

• Construct Validity

• Content Validity

• Convergent Validity

• Discriminant Validity

• Test Reliability

• Internal Consistency

• Factor Analysis

• Confirmatory Factor Analysis

• Exploratory Factor Analysis

• Principal Component Analysis

• Test Sensitivity

• Test Specificity

Population Details

• Location: Sierra Leone

• Respondents: Pregnant Women; New Mothers

Age Group

• Adulthood (18 yrs & older)

Population Group

• Human

• Female

Test Type

Original

Instrument Type

Rating Scale

Format

The SLPPDS response format used jerry cans as visual aids (T. S. Betancourt et al., 2015) to represent a four-point Likert scale.

Language Available

• Krio (Creole, Patois)

• English

Keywords

Cut-Off Point; Face Validity; Perinatal Psychological Distress; Screening; Diagnostic Validity; African Cultural Groups; Cutting Scores; Distress; Perinatal Period; Face Validity; Mental Health Screening

Test Year

2025

Author

Bah, Abdulai Jawo; Wurie, Haja Ramatulai; Samai, Mohamed; Horn, Rebecca; Ager, Alastair

Author ORCID Identifier

• Bah, Abdulai Jawo: http://orcid.org/0000-0002-3334-7882

• Horn, Rebecca: http://orcid.org/0000-0002-9869-544X

• Ager, Alastair: http://orcid.org/0000-0002-9474-3563

Affiliation

• Bah, Abdulai Jawo: Institute for Global Health and Development, Queen Margaret University

• Wurie, Haja Ramatulai: College of Medicine and Allied Health Sciences, University of Sierra Leone

• Samai, Mohamed: College of Medicine and Allied Health Sciences, University of Sierra Leone

• Horn, Rebecca: Institute for Global Health and Development, Queen Margaret University

• Ager, Alastair: Institute for Global Health and Development, Queen Margaret University

Email

Bah, Abdulai Jawo: [email protected]

Files

No data is Available

Permissions

Contact Corresponding Author

Fee

No

Correspondence Address

Bah, Abdulai Jawo: [email protected]

Reference’s

Bah, A. J., Wurie, H. R., Samai, M., Horn, R., & Ager, A. (2025). Developing and validating the Sierra Leone perinatal psychological distress scale through an emic-etic approach. Journal of Affective Disorders Reports, 19, Article 100852. https://doi.org/10.1016/j.jadr.2024.100852

Items of the Sierra Leone Perinatal Psychological Distress Scale (SLPPDS)

• This is a 10-item measure.