Development of a revised and abbreviated version of the postpartum bonding questionnaire (PBQ-R): First U.S. validation and association to child outcomes

Abstract

The postpartum bonding questionnaire (PBQ) is a maternal-reported 25-item measure of bonding, available in 15 languages, and widely used for clinical and research purposes in the United States (U.S.) and across the globe. Nonetheless, its putative 4-factor structure initially proposed in 2001 has never generalized or been replicated in other samples, nor has it been studied in U.S. populations. Using a U.S.-based sample of 610 English-speaking mothers who completed the PBQ 4 months postpartum—mean 32.51 ± 5.25 years old and 47.5% first-time mothers—the initial goal of this study was to confirm the 4-factor/25-item structure of the PBQ. Aligned with other published studies, our confirmatory factor analysis did not support the 4-factor/25-item structure. We then used exploratory factor analysis which supported the creation of a 1-factor/14-item abbreviated measure, the PBQ-R. Unlike previous versions of the PBQ, the PBQ-R is scored so that higher scores indicate stronger bonding. The validity of the PBQ-R was supported by its high internal consistency in this sample (w = 0.89), and correlations with maternal depression (ρ = −0.46) and child neurodevelopment (ρ = 0.11 to ρ = 22) and socio-emotional symptoms (ρ = −0.22 to ρ = −0.33). The new unidimensional shorter PBQ-R is suitable for use in the U.S. as a measure of general mother-infant bonding.