Identifying underlying factors in risk factors and emotional sequelae self-attributed to abortion: development and validation of a brief assessment tool
CLI Summary
This study measured predictors for negative mental and emotional outcomes after abortion based on risk factors identified by the American Psychological Association. The study found two major areas that align with risk factors: 1) attachment and support (bigger effect) and 2) moral and maternal conflict (smaller effect). “Attachment and support” includes emotional attachment, perceived pressure, and lack of support from others. The findings could be used to develop a screening tool to identify women who are particularly at risk of negative outcomes after abortion.
Abstract
Background
Risk factors for adverse emotional and psychological reactions to abortion have not been studied for their interactions. This study used factor analytic methods to develop concise screening scales for pre-abortion risk and post-abortion outcomes.
Methods
A topic-blind electronic survey was administered to a random sample of U.S. women aged 41–45. Among 2,191 respondents with reproductive histories, 466 (21.3%) reported a prior induced abortion; 409 completed the full survey. Participants rated 10 risk-factor and 25 outcome statements using 0–100 visual analog scales. Exploratory factor analysis (EFA) identified latent constructs, confirmatory factor analysis (CFA) tested model fit, and structural equation modeling (SEM) assessed relationships between risk and outcome factors.
Results
Risk-factor EFA supported two domains: attachment/support and internal conflict. Outcome EFA identified three domains: internalized distress, intrusive symptoms, and behavioral risks. CFA demonstrated good fit (CFI > .90; RMSEA < .08). SEM showed attachment/support more strongly predicted internalized distress (β = .65), intrusive symptoms (β = .58), and behavioral risks (β = .34) than internal conflict (β = .21–.30). Attachment/support and behavioral risks predicted greater survey-related stress (R² = .30).
Conclusions
Two core risk dimensions predict post-abortion emotional and behavioral outcomes, supporting further development of factor-based screening tools for counseling.
