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Effectiveness of a guided ACT-based self-help resilience training for depressive symptoms during pregnancy: Study protocol of a randomized controlled trial embedded in a prospective cohort
- Source :
- BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-12 (2020), BMC Pregnancy and Childbirth, 20(1):705. BMC, BMC pregnancy and childbirth, 20(1):705. BioMed Central, BMC Pregnancy and Childbirth, BMC Pregnancy and Childbirth, 20(1):705. BioMed Central, BMC pregnancy and childbirth
- Publication Year :
- 2020
- Publisher :
- BMC, 2020.
-
Abstract
- Background During pregnancy, about 10 to 20% of women experience depressive symptoms. Subclinical depression increases the risk of peripartum depression, maternal neuro-endocrine dysregulations, and adverse birth and infant outcomes. Current treatments often comprise face-to-face psychological or pharmacological treatments that may be too intensive for women with subclinical depression leading to drop-out and moderate effectiveness. Therefore, easily accessible, resilience enhancing and less stigmatizing interventions are needed to prevent the development of clinical depression. This paper describes the protocol of a prospective cohort study with an embedded randomized controlled trial (RCT) that aims to improve mental resilience in a sample of pregnant women through a self-help program based on the principles of Acceptance and Commitment Therapy (ACT). Maternal and offspring correlates of the trajectories of peripartum depressive symptoms will also be studied. Methods Pregnant women (≥ 18 years) receiving care in Dutch midwifery practices will participate in a prospective cohort study (n ~ 3500). Between 12 and 18 weeks of pregnancy, all women will be screened for depression with the Edinburgh Postnatal Depression Scale (EPDS). Women with an EPDS score ≥ 11 will be evaluated with a structured clinical interview. Participants with subclinical depression (n = 290) will be randomized to a 9-week guided self-help ACT-training or to care as usual (CAU). Primary outcomes (depressive symptoms and resilience) and secondary outcomes (e.g. anxiety and PTSD, bonding, infant development) will be collected via online questionnaires at four prospective assessments around 20 weeks and 30 weeks gestation and at 6 weeks and 4 months postpartum. Maternal hair cortisol concentrations will be assessed in a subsample of women with a range of depressive symptoms (n = 300). The intervention’s feasibility will be assessed through qualitative interviews in a subsample of participants (n = 20). Discussion This is the first study to assess the effectiveness of an easy to administer intervention strategy to prevent adverse mental health effects through enhancing resilience in pregnant women with antepartum depressive symptomatology. This longitudinal study will provide insights into trajectories of peripartum depressive symptoms in relation to resilience, maternal cortisol, psychological outcomes, and infant developmental milestones. Trial registration Netherlands Trial Register (NTR), NL7499. Registered 5 February 2019.
- Subjects :
- Longitudinal study
Maternal and child health
Psychological intervention
Acceptance and commitment therapy
Cortisol
law.invention
Study Protocol
0302 clinical medicine
POSTTRAUMATIC-STRESS-DISORDER
Randomized controlled trial
law
Pregnancy
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Randomized Controlled Trials as Topic
COMMITMENT THERAPY
PERINATAL MOOD
Depression
PRIMARY-CARE
Obstetrics and Gynecology
Resilience, Psychological
Treatment Outcome
Health
Anxiety
Female
medicine.symptom
MENTAL-HEALTH
Adult
medicine.medical_specialty
ANXIETY DISORDERS
Peripartum depression, Resilience, Psychological outcome, Infant development, Cortisol
lcsh:Gynecology and obstetrics
03 medical and health sciences
MATERNAL STRESS
medicine
Humans
Acceptance and Commitment Therapy
Psychiatry
lcsh:RG1-991
Psychiatric Status Rating Scales
Psychological outcome
Peripartum depression
Resilience
business.industry
Infant development
POSTPARTUM DEPRESSION
Mental health
Pregnancy Complications
Self Care
PSYCHOMETRIC PROPERTIES
Edinburgh Postnatal Depression Scale
RISK-FACTORS
Human medicine
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 14712393
- Database :
- OpenAIRE
- Journal :
- BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-12 (2020), BMC Pregnancy and Childbirth, 20(1):705. BMC, BMC pregnancy and childbirth, 20(1):705. BioMed Central, BMC Pregnancy and Childbirth, BMC Pregnancy and Childbirth, 20(1):705. BioMed Central, BMC pregnancy and childbirth
- Accession number :
- edsair.doi.dedup.....99a5597c8e1b0f8cb97481c6daa389ae