Cognitive-behavioral therapy as a damper of the negative psychological effects of confinement by COVID-19 on pregnant women

e202103014

Authors

  • Jose A. Puertas-Gonzalez Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC). Granada. España. / Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Facultad de Psicología. Universidad de Granada. Granada. España.
  • Borja Romero-Gonzalez Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC). Granada. España. / Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Facultad de Psicología. Universidad de Granada. Granada. España.
  • Carolina Mariño-Narvaez Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC). Granada. España.
  • Milagros Cruz-Martinez Departamento de Obstetricia y Ginecología del Hospital Universitario Clínico San Cecilio. Granada. España.
  • Maria Isabel Peralta-Ramirez Departamento de Personalidad, Evaluación y Tratamiento Psicológico. Facultad de Psicología. Universidad de Granada. Granada. España.

Keywords:

Cognitive-behavioral therapy, Pregnant women, Resilience, Stress

Abstract

Background: The pandemic caused by COVID-19, at a psychological level, can cause an increase in levels of stress and anxiety due to the fear of contagion and its consequences. Pregnant women are especially vulnerable to these psychological consequences. Thus, the objective of this study was to verify the efficacy of a cognitive-behavioral stress control program in reducing psychological stress and increasing resilience in pregnant women, which ended at the begining of the confinement due to COVID-19 in Spain.
Methods: The study included 22 pregnant women who were randomly divided into two groups: the experimental group (GT) consisted of 11 participants and the control group (GC) also consisted of 11 participants. Participants were recruited from the Hospital Universitario Clínico San Cecilio in the province of Granada (Spain), where the weekly cognitive behavioral intervention was also carried out, which was implemented between January 22 and March 11, 2020. They used the assessment instruments: Pregnancy Distress Questionnaire (PDQ), Perceived Stress Scale (EEP-14), Inventory of Vulnerability to Stress (IVE) and Connor Davidson Resilience Scale (CD-RISC). A mixed ANOVA of repeated measures 2*2 was performed, with the variable between groups having two levels (CG and GT), and the within-subject having two time periods (pre and post).
Results: The repeated measures ANOVA analysis showed group*time interaction effects between the therapy group and the control group and the CD-RISC scores (F1,20=10.658; p<0.02). Intrasubject differences in CD-RISC scores were found in the (GT) (t=-2.529; p<0.05), with a moderate effect size.
Conclusions: It can be affirmed that cognitive behavioral intervention in pregnant women, administrated prior to confinement in Spain and during the COVID-19 pandemic, has resulted in increased levels of resilience in this population.

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References

Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L et al. Mental health care for medical staff in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020; 7(4): e15-e16.

World Health Organization (WHO). Statement on the meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). WHO Newsl. 2020.

Chan JFW, Yuan S, Kok KH, To KKW, Chu H, Yang J et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020; 395(10223): 514-523

Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. The Lancet. 2020; 395(10223): 470-473

Wang Y, Di Y, Ye J, Wei W. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol Heal Med. 2020; 1-10.

Christian LM. Physiological reactivity to psychological stress in human pregnancy: Current knowledge and future directions. Progress in Neurobiology. 2012; 99(2): 106-116.

Dunkel Schetter C, Lobel M, Pregnancy and birth outcomes: A multilevel analysis of prenatal maternal stress and birth weight, Handb. Heal. Psychol, 2nd Ed, 2012.

Palladino CL, Singh V, Campbell J, Flynn H, Gold KJ. Homicide and Suicide During the Perinatal Period. Obstet. Gynecol. 2012; 32(4): 217-218.

Woods SM, Melville JL, Guo Y, Fan MY, Gavin A. Psychosocial stress during pregnancy. Am. J. Obstet. Gynecol. 2010; 202(1): 61-e1.

Wu Y, Zhang C, Liu H, Duan C, Li C, Fan J et al. Perinatal depressive and anxiety symptoms of pregnant women along with COVID-19 outbreak in China. Am J Obstet Gynecol. 2020.

Kourtis AP, Read JS, Jamieson DJ. Pregnancy and infection. New England Journal of Medicine. 2014; 370(23): 2211-2218.

Caparros-Gonzalez RA, Romero-Gonzalez B, Strivens-Vilchez H, Gonzalez-Perez R, Martinez-Augustin O, Peralta-Ramirez MI. Hair cortisol levels, psychological stress and psychopathological symptoms as predictors of postpartum depression. PLoS One. 2017; 12(8): e0182817.

Kaboli KS, Mahmoodi Z, Tourzani Z, Tehranizadeh M, Kabir K, Dolatian M. The effect of group counseling based on cognitive-behavioral approach on pregnancy-specific stress and anxiety. Shiraz E Med J. 2017; 18(5).

Romero-Gonzalez B, Puertas-Gonzalez JA, Strivens-Vilchez H, Gonzalez-Perez R, Peralta-Ramirez MI. Effects of cognitive-behavioural therapy for stress management on stress and hair cortisol levels in pregnant women: A randomised controlled trial. J Psychosom Res. 2020; 110162.

Dunn C, Hanieh E, Roberts R, Powrie R. Mindful pregnancy and childbirth: effects of a mindfulness-based intervention on women’s psychological distress and well-being in the perinatal period, Arch. Womens. Ment. Health. 2012; 15(2): 139-143.

Shi Z, MacBeth A. The effectiveness of mindfulness-based interventions on maternal perinatal mental health outcomes: a systematic review, Mindfulness (N. Y). 2017; 8(4): 823-847.

Tomfohr-Madsen LM, Campbell TS, Giesbrecht GF, Letourneau BL, Carlson LE, Madsen JW, Dimidjian S. Mindfulness-based cognitive therapy for psychological distress in pregnancy: study protocol for a randomized controlled trial, Trials. 2016; 17(1): 1-12.

Toosi M, Akbarzadeh M, Zare N, Sharif F. The Role of Relaxation Training to Pregnant Mothers on Health Index of Infants. Pars Jahrom Univ Med Sci [Internet]. 2013 Apr 1 [cited 2020 Jul 2];11(1):15–21. Available from: http://jmj.jums.ac.ir/article-1-36-en.html

Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clin Psychol Rev. 2006: 26(1): 17-31.

Caparros-Gonzalez RA, Perra O, Alderdice F, Lynn F, Lobel M, García-García I et al. Psychometric validation of the Prenatal Distress Questionnaire (PDQ) in pregnant women in Spain. Women Heal. 2019; 59(8): 937-952.

Yali AM, Lobel M. Coping and distress in pregnancy: An investigation of medically high risk women. J Psychosom Obstet Gynaecol. 1999; 20(1); 39-52.

Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983; 385-396.

Remor E. Psychometric properties of a European Spanish version of the perceived stress scale (PSS), Span. J. Psychol. 2006; 9(1): 86-93.

Connor KM, Davidson JRT. Development of a new Resilience scale: The Connor-Davidson Resilience scale (CD-RISC). Depress Anxiety. 2003; 18(2): 76-82.

Robles-Ortega H, Peralta-Ramírez MI, Navarrete-Navarrete N. Validación de la versión española del inventarío de vulnerabilidad al estrés de Beech, Burns y Scheffield. Avances en psicología de la salud. 2006; 62.

Robles-Ortega H, Peralta-Ramírez MI. Programa para control del estrés (manuales prácticas), 2nd ed. Madrid: Ediciones Pirámide; 2010.

Ellis A, Bernad M. Reason and Emotion in Psychotherapy: Revised and updated. New York: Birch Lane; 1994.

Beck AT. Cognitive Therapy and Emotional Disorders. New York. New York: International Universities; 1976.

Beck AT, Emery G. Anxiety disorders and phobias: A cognitive perspective. New York: Basic; 1985.

Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy of Depression. New York: Guilford; 1979.

Cohen J. Statistical power analysis for the behavioral sciences (revised ed.). New York: Academic Press; 1988.

Fletcher D, Sarkar M. Psychological resilience: A review and critique of definitions, concepts, and theory. European psychologist. 2013; 18(1): 12.

Liu TB, Chen XY, Miao GD, Zhang L. Zhang Q, Cheung T. Recommendations on diagnostic criteria and prevention of SARS-related mental disorders. J Clin Psychol Med. 2003; 13(3): 188-91

Maunder R, Hunter J, Vincent L, Bennett J, Peladeau N, Leszcz M et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ. 2003; 168(10): 1245-1251.

Zaheri H, Najar S, Abbaspoor Z. Effectiveness of cognitive-behavioral stress management on psychological stress and glycemic control in gestational diabetes: a randomized controlled trial. J Matern Neonatal Med. 2017; 30(11): 1378-1382.

Rallis S, Skouteris H, McCabe M, Milgrom J. A prospective examination of depression, anxiety and stress throughout pregnancy. Women and Birth. 2014; 27(4): e36-e42.

Published

2021-03-12

How to Cite

1.
Puertas-Gonzalez JA, Romero-Gonzalez B, Mariño-Narvaez C, Cruz-Martinez M, Peralta-Ramirez MI. Cognitive-behavioral therapy as a damper of the negative psychological effects of confinement by COVID-19 on pregnant women: e202103014. Rev Esp Salud Pública [Internet]. 2021 Mar. 12 [cited 2024 Jul. 5];95:10 páginas. Available from: https://ojs.sanidad.gob.es/index.php/resp/article/view/636

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