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CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety

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Abstract

Many women experience anxiety during pregnancy with potential negative effects on maternal, birth, and child outcomes. Because of potential risks of fetal exposure to psychotropic medications, efficacious non-pharmacologic approaches are urgently needed. However, no published studies of psychotherapeutic treatments for anxiety in pregnancy exist. Mindfulness-based cognitive therapy (MBCT) may substantially reduce anxiety and co-morbid symptoms in people with anxiety disorders. Coping with Anxiety through Living Mindfully (CALM) Pregnancy is an adaptation of MBCT designed to address anxiety in pregnant women. This study examined the feasibility, acceptability, and clinical outcomes of the CALM Pregnancy intervention in pregnant women anxiety. Twenty-four pregnant women with generalized anxiety disorder (GAD) or prominent symptoms of generalized anxiety participated in an open treatment trial of the CALM Pregnancy group intervention. Psychiatric diagnoses were determined by structured clinical interview, and self-report measures of anxiety, worry, depression, self-compassion, and mindfulness were completed at baseline and post-intervention. Qualitative feedback was elicited via questionnaire. Twenty-three participants completed the intervention with high attendance and good compliance with home practice. Completers showed statistically and clinically significant improvements in anxiety, worry, and depression, and significant increases in self-compassion and mindfulness. Of the 17 participants who met GAD criteria at baseline, only one continued to meet criteria post-intervention. Participants regarded their experience in the intervention to be overwhelmingly positive. MBCT in the form of the CALM Pregnancy intervention holds potential to provide effective, non-pharmacological treatment for pregnant women with anxiety. These promising findings warrant further testing of the intervention with a randomized controlled trial.

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Acknowledgments

This research was funded in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (1R21HD065156-01) to Dr. Goodman. We would also like to extend our gratitude to Fredda Zuckerman LICSW and the volunteer staff who facilitated recruitment at Massachusetts General Hospital Obstetrics and to the women who participated in the study. Special thanks to L. Klein for creating the CALM acronym.

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Authors and Affiliations

  1. MGH Institute of Health Professions, School of Nursing, 36 1st Ave, Boston, MA, 02129, USA

    Janice H. Goodman, Anthony Guarino, Kerry Chenausky, Lauri Klein, Joanna Prager, Rebecca Petersen & Avery Forget

  2. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Marlene Freeman

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  1. Janice H. Goodman
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Correspondence to Janice H. Goodman.

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Goodman, J.H., Guarino, A., Chenausky, K. et al. CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Arch Womens Ment Health 17, 373–387 (2014). https://doi.org/10.1007/s00737-013-0402-7

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