Cognitive Processing Therapy (CPT) for Perinatal Posttraumatic Stress Disorder (PTSD)

PTSD Checklist for DSM-5 (PCL-5) will be used to collect information on PTSD symptoms. The PCL-5 for DSM-5 is a 20-item self-report measure. Higher scores reflect greater PTSD severity. Scoring is based on how much the patient has been bothered by the symptoms on a scale from "0 = not at all" to "4 = extremely." PCL-5 total symptom severity scores range from 0 to 80 with higher scores indicating greater PTSD severity. PCL-5 Monthly will be collected at Visit 1, and the PCL-5 weekly will be collected at 1 week, 4 weeks, 8 weeks, 12 weeks, and 16 weeks following initiation of treatment in both groups.

The Patient Health Questionnaire-9 (PHQ-9) is used for screening, diagnosing, monitoring, and measuring the severity of depression. Nine questions each scored from 0 (Not at all) to 3 (Nearly every day). Total score ranging from 0 to 27, with higher scores indicating more severe depression: 1 - 4: Minimal or no depression, 5 - 9: Mild depression, 10 - 14: Moderate depression, 15 - 19: Moderately severe depression, and 20 - 27: Severe depression

The Prenatal Attachment Inventory (PAI) is a 21-item questionnaire designed to assess a pregnant woman's thoughts, feelings, and experiences related to her unborn child and her level of attachment to the fetus. It uses a 4-point Likert scale for each item (4 = almost always; 3 = often; 2 = sometimes, 1 = almost never), with scores ranging from 21 to 84, where higher scores indicate a stronger prenatal attachment.

The Maternal Attachment Inventory (MAI) is a 26-item, self-report questionnaire used to assess the emotional bond between a mother and her infant. It measures maternal feelings and behaviors that reflect affection and love for the baby. Higher scores on the MAI indicate a stronger maternal attachment. The scale utilizes a four-point Likert scale for responses (4 = almost always; 3 = often; 2 = sometimes, 1 = almost never), and the total score ranges from 26 to 104.

The Infant CARE-Index assesses parent-infant interaction. It is a videotaped 3-5 minute free-play observation in which the adult is asked 'to play with your child as you usually would'. Gives an assessment of the best of their potential interaction at times of low stress, i.e ideal functioning, but the scores are highly correlated with attachment. The Infant CARE-Index (ICI) is unique because it can be used from birth to 15 months and in multiple locations. The videotapes are coded by reliable coders who are blind to all information about the dyad. Based on directions in the manual, the ICI yields: Adult scores on sensitivity, control, and unresponsiveness; Infant scores on cooperation, compulsivity, difficultness, and passivity. A dyadic synchrony indicative of the degree of risk to the child's future development.