Posted: 02.07.2014 | by AMRA

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Between 10-40% of women develop significant anxiety during pregnancy, an unsurprising fact given the associated physiological, hormonal, and lifestyle changes, and concerns about the impending responsibilities of parenthood. Perinatal anxiety is a risk factor for obstetrical complications and postpartum depression, and pharmacologic interventions are often contra-indicated. This underscores the need for effective behavioral treatments. Goodman et al. [Archives of Women’s Mental Health] designed an MBCT-derived intervention called CALM (Coping with Anxiety through Living Mindfully) Pregnancy to treat perinatal anxiety. A sample of 24 pregnant women with either generalized anxiety disorder (GAD) or significant GAD symptoms (as assessed through structured clinical interview) were enrolled in the program. Attendance and compliance were good, with 23 women (96%) successfully completing the 8-week group-based program.

Participants reported large and significant reductions in anxiety, worry and depression, and large and significant increases in self-compassion and dispositional mindfulness (as measured by the MAAS). Of the 16 participants who met the full diagnostic criteria for GAD at baseline, only 1 met the criteria at program completion. Similarly, the two women who met the diagnostic criteria for major depressive disorder at baseline no longer met the criteria at program completion. In an open-ended interview about what they had found most helpful, participants mentioned skill building, connection, universality, acceptance and self-kindness, decreased reactivity, cognitive changes, and insight.

This pilot study demonstrates the feasibility, acceptability, and potential effectiveness of the CALM Pregnancy program, at least for a population of mostly Caucasian, middle class, well-educated women. Future studies using randomly assigned controls will be needed to confirm the early promise of these findings in this and more diverse groups of women.

Reference:

Goodman, J. H., Guarino, A., Chenausky, K., Klein, L., Prager, J., Petersen, R., . . . Freeman, M. (2014). CALM pregnancy: Results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Archives of Women’s Mental Health. doi: 10.1007/s00737-013-0402-7. [PMID: 24449191]

[Link to abstract]