The effectiveness of emotion regulation group training in reducing depression, anxiety, and stress symptoms in women during pregnancy
Researcher Bulletin of Medical Sciences,
Vol. 26 No. 1 (2021),
30 October 2021
,
Page e19
Abstract
Background: Pregnancy and childbirth is a natural function but it is also a stressful and critical period that increases women’s vulnerability to psychological problems and also increases the mental health problems of the woman and her fetus, so they need interventions to improve maternal health during this time. This study investigated the effectiveness of emotion regulation group training in reducing depression, anxiety, and stress symptoms in women during pregnancy and postpartum.
Materials and Methods: This quasi-experimental study had a pre-test, post-test and follow-up (2 months follow after delivery). The study population consisted of 31 pregnant women who were randomly divided into intervention (n = 15) and control (n = 16) groups. The Depression, Anxiety and Stress Questionnaire (DASS-21) was used in this study. Eight sessions of emotion regulation group training were administered to the intervention group and the control group received information about pregnancy and childbirth during 4 sessions. After intervention and also two months after delivery, the questionnaires were completed again. The results of the scales were analyzed by SPSS software using repeated measures analysis of variance.
Results: The data analysis showed that depression, anxiety and stress in the intervention group are decreasing from pre-test to post-test and follow-up significantly more than control group.
Conclusion: According to the results of this study, emotion regulation group training can be effective in reducing of depression, anxiety and stress symptoms in pregnant women.
Keywords:
- Emotion regulation group training; Depression; Anxiety; Stress; Pregnant women
How to Cite
Ameli, S. ., Aslzaker , M. ., Salehpour, S. ., & Jafari , M. . (2022). The effectiveness of emotion regulation group training in reducing depression, anxiety, and stress symptoms in women during pregnancy. Researcher Bulletin of Medical Sciences, 26(1), e19. Retrieved from https://theses.sbmu.ac.ir/index.php/rbms/article/view/38984
References
1. Agampodi, S. B., & Agampodi, T. C. (2013). Antenatal depression in Anuradhapura, Sri Lanka and the factor structure of the Sinhalese version of Edinburgh post partum depression scale among pregnant women. PLoS One, 8(7), e69708.
2. Ali, A. M. M., Fouad, S., Parvin, D., & Jafar, Z. Preliminary Study of the Reliability and validity of Depression, Anxiety and Stress Scales (DASS) in Non-Clinical Samples.
3. Association, A. P. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub.
4. Austin, M.-P., Frilingos, M., Lumley, J., Hadzi-Pavlovic, D., Roncolato, W., Acland, S., . . . Parker, G. (2008). Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: a randomised controlled trial. Journal of affective disorders, 105(1), 35-44.
5. Avni-Barron, O., & Wiegartz, P. S. (2011). Issues in treating anxiety disorders in pregnancy. Psychiatr Times, 28, 47-50.
6. Bales, M., Pambrun, E., Melchior, M., Glangeaud-Freudenthal, N.-C., Charles, M.-A., Verdoux, H., & Sutter-Dallay, A.-L. (2015). Prenatal psychological distress and access to mental health care in the ELFE cohort. European Psychiatry, 30(2), 322-328.
7. Berking, M., Ebert, D., Cuijpers, P., & Hofmann, S. G. (2013). Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: a randomized controlled trial. Psychotherapy and Psychosomatics, 82(4), 234-245.
8. Berking, M., Wirtz, C. M., Svaldi, J., & Hofmann, S. G. (2014). Emotion regulation predicts symptoms of depression over five years. Behaviour research and therapy, 57, 13-20.
9. Couret, D., Jamin, A., Kuntz-Simon, G., Prunier, A., & Merlot, E. (2009). Maternal stress during late gestation has moderate but long-lasting effects on the immune system of the piglets. Veterinary immunology and immunopathology, 131(1), 17-24.
10. Dikmen-Yildiz, P., Ayers, S., & Phillips, L. (2017). Factors associated with post-traumatic stress symptoms (PTSS) 4–6 weeks and 6 months after birth: A longitudinal population-based study. Journal of affective disorders, 221, 238-245.
11. Dunn, C., Hanieh, E., Roberts, R., & Powrie, R. (2012). Mindful pregnancy and childbirth: effects of a mindfulness-based intervention on women’s psychological distress and well-being in the perinatal period. Archives of women's mental health, 15(2), 139-143.
12. Foruzande, N. (2000). Prevalence and predisposing factors of post-partum depression among women referred to the health care centers of Shahrekord, 1996. Journal of Shahrekord University of Medical Sciences, 2(1), 43-51.
13. Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior Therapy, 37(1), 25-35.
14. Gross, J. J., & Jazaieri, H. (2014). Emotion, emotion regulation, and psychopathology: An affective science perspective. Clinical Psychological Science, 2(4), 387-401.
15. Guszkowska, M., Langwald, M., Zaremba, A., & Dudziak, D. (2014). The correlates of mental health of well-educated Polish women in the first pregnancy. Journal of Mental Health, 23(6), 328-332.
16. Halbreich, U., & Karkun, S. (2006). Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. Journal of affective disorders, 91(2), 97-111.
17. Hall, W. A., Hauck, Y. L., Carty, E. M., Hutton, E. K., Fenwick, J., & Stoll, K. (2009). Childbirth fear, anxiety, fatigue, and sleep deprivation in pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38(5), 567-576.
18. Ham Jr, J. T., & Klimo, J. (2000). Fetal awareness of maternal emotional states during pregnancy. Journal of Prenatal & Perinatal Psychology & Health, 15(2), 118.
19. Huizink, A. C., Mulder, E. J., de Medina, P. G. R., Visser, G. H., & Buitelaar, J. K. (2004). Is pregnancy anxiety a distinctive syndrome? Early human development, 79(2), 81-91.
20. Kamali, A., Vaghee, S., Asgharipour, N., & Behnam vashani, H. R. (2016). The impact of Emotion Regulation Training on Mental health in Mothers of Children with attention deficit/hyperactivity Disorder. Journal of Torbat Heydariyeh University of Medical Sciences, 4(3), 16-23.
21. Karami, K., Mardani, A., ShakeriNejad, G., & Saki, A. (2015). Effectiveness of A Codified Educational Behavioral Program on the Mental Health of Pregnant Women. SSU_Journals, 23(9), 879-889.
22. Kingston, D., Janes-Kelley, S., Tyrrell, J., Clark, L., Hamza, D., Holmes, P., . . . Austin, M.-P. (2015). An integrated web-based mental health intervention of assessment-referral-care to reduce stress, anxiety, and depression in hospitalized pregnant women with medically high-risk pregnancies: a feasibility study protocol of hospital-based implementation. JMIR research protocols, 4(1).
23. Kohman, R. A., Tarr, A. J., Day, C. E., McLinden, K. A., & Boehm, G. W. (2008). Influence of prenatal stress on behavioral, endocrine, and cytokine responses to adulthood bacterial endotoxin exposure. Behavioural brain research, 193(2), 257-268.
Kugu, N., & Akyuz, G. (2001). Psychological state in pregnancy. Journal of the Faculty of Medicine Cumhuriyet University, 23(1), 61-64.
24. McCubbin, J. A. (2009). Prenatal maternal stress hormones, risk for hypertension, and the neonatal pain response: Comment on France et al.,“Maternal family history of hypertension attenuates neonatal pain response”. Pain, 142(3), 173.
25. Mehrabi A, T. Z., Mohamadi A. (2015). emotion regulation psychotherapy, Introduction to the Third Generation of Cognitive Behavioral Therapies. 150-155.
26. Melville, J. L., Gavin, A., Guo, Y., Fan, M.-Y., & Katon, W. J. (2010). Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstetrics and gynecology, 116(5), 1064.
27. Mennin, D. S., Fresco, D. M., Ritter, M., & Heimberg, R. G. (2015). An open trial of emotion regulation therapy for generalized anxiety disorder and cooccurring depression. Depression and Anxiety, 32(8), 614-623.
28. Nesayan, A., Hosseini, B., & Asadi Gandomani, R. (2017). The Effectiveness of Emotion Regulation Skills Training on Anxiety and Emotional Regulation Strategies in Adolescent Students. Practice in Clinical Psychology, 5(4), 263-270.
29. Osman, A., Wong, J. L., Bagge, C. L., Freedenthal, S., Gutierrez, P. M., & Lozano, G. (2012). The depression anxiety stress Scales—21 (DASS‐21): further examination of dimensions, scale reliability, and correlates. Journal of clinical psychology, 68(12), 1322-1338.
30. Otley, H. (2011). Fear of childbirth: Understanding the causes, impact and treatment. British Journal of Midwifery, 19(4).
31. Pallarés, M. E., Bernasconi, P. A. S., Feleder, C., & Cutrera, R. A. (2007). Effects of prenatal stress on motor performance and anxiety behavior in Swiss mice. Physiology & behavior, 92(5), 951-956.
32. Parsons, C. E., Young, K. S., Rochat, T. J., Kringelbach, M., & Stein, A. (2012). Postnatal depression and its effects on child development: a review of evidence from low-and middle-income countries. British medical bulletin, 101(1).
33. Patel, V., Rahman, A., Jacob, K., & Hughes, M. (2004). Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia. BMJ: British Medical Journal, 328(7443), 820.
34. Seng, J. S., D'andrea, W., & Ford, J. D. (2014). Complex mental health sequelae of psychological trauma among women in prenatal care. Psychological Trauma: Theory, Research, Practice, and Policy, 6(1), 41.
35. Sherwen, L. N., Scoloveno, M. A., & Weingarten, C. T. (1995). Nursing care of the childbearing family: McGraw-Hill/Appleton & Lange.
36. Sobhi-Gharamaleki, N., Porzoor, P., Aghajani, S., & Narimani, M. (2015). Effectiveness of emotion regulation training on reduction of anxiety, stress and depression symptoms among University students. Iranian Journal of Health Education & Promotion, 3(1), 5.
37. Toosi, M., Akbarzadeh, M., Zare, N., & Sharif, F. (2011). Effect of attachment training on anxiety and attachment behaviors of first-time mothers. Journal of hayat, 17(3), 69-79.
38. Verreault, N., Da Costa, D., Marchand, A., Ireland, K., Dritsa, M., & Khalifé, S. (2014). Rates and risk factors associated with depressive symptoms during pregnancy and with postpartum onset. Journal of psychosomatic obstetrics & gynecology, 35(3), 84-91.
39. Wirtz, C. M., Hofmann, S. G., Riper, H., & Berking, M. (2014). Emotion regulation predicts anxiety over a five‐year interval: A cross‐lagged panel analysis. Depression and Anxiety, 31(1), 87-95.
2. Ali, A. M. M., Fouad, S., Parvin, D., & Jafar, Z. Preliminary Study of the Reliability and validity of Depression, Anxiety and Stress Scales (DASS) in Non-Clinical Samples.
3. Association, A. P. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub.
4. Austin, M.-P., Frilingos, M., Lumley, J., Hadzi-Pavlovic, D., Roncolato, W., Acland, S., . . . Parker, G. (2008). Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: a randomised controlled trial. Journal of affective disorders, 105(1), 35-44.
5. Avni-Barron, O., & Wiegartz, P. S. (2011). Issues in treating anxiety disorders in pregnancy. Psychiatr Times, 28, 47-50.
6. Bales, M., Pambrun, E., Melchior, M., Glangeaud-Freudenthal, N.-C., Charles, M.-A., Verdoux, H., & Sutter-Dallay, A.-L. (2015). Prenatal psychological distress and access to mental health care in the ELFE cohort. European Psychiatry, 30(2), 322-328.
7. Berking, M., Ebert, D., Cuijpers, P., & Hofmann, S. G. (2013). Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: a randomized controlled trial. Psychotherapy and Psychosomatics, 82(4), 234-245.
8. Berking, M., Wirtz, C. M., Svaldi, J., & Hofmann, S. G. (2014). Emotion regulation predicts symptoms of depression over five years. Behaviour research and therapy, 57, 13-20.
9. Couret, D., Jamin, A., Kuntz-Simon, G., Prunier, A., & Merlot, E. (2009). Maternal stress during late gestation has moderate but long-lasting effects on the immune system of the piglets. Veterinary immunology and immunopathology, 131(1), 17-24.
10. Dikmen-Yildiz, P., Ayers, S., & Phillips, L. (2017). Factors associated with post-traumatic stress symptoms (PTSS) 4–6 weeks and 6 months after birth: A longitudinal population-based study. Journal of affective disorders, 221, 238-245.
11. Dunn, C., Hanieh, E., Roberts, R., & Powrie, R. (2012). Mindful pregnancy and childbirth: effects of a mindfulness-based intervention on women’s psychological distress and well-being in the perinatal period. Archives of women's mental health, 15(2), 139-143.
12. Foruzande, N. (2000). Prevalence and predisposing factors of post-partum depression among women referred to the health care centers of Shahrekord, 1996. Journal of Shahrekord University of Medical Sciences, 2(1), 43-51.
13. Gratz, K. L., & Gunderson, J. G. (2006). Preliminary data on an acceptance-based emotion regulation group intervention for deliberate self-harm among women with borderline personality disorder. Behavior Therapy, 37(1), 25-35.
14. Gross, J. J., & Jazaieri, H. (2014). Emotion, emotion regulation, and psychopathology: An affective science perspective. Clinical Psychological Science, 2(4), 387-401.
15. Guszkowska, M., Langwald, M., Zaremba, A., & Dudziak, D. (2014). The correlates of mental health of well-educated Polish women in the first pregnancy. Journal of Mental Health, 23(6), 328-332.
16. Halbreich, U., & Karkun, S. (2006). Cross-cultural and social diversity of prevalence of postpartum depression and depressive symptoms. Journal of affective disorders, 91(2), 97-111.
17. Hall, W. A., Hauck, Y. L., Carty, E. M., Hutton, E. K., Fenwick, J., & Stoll, K. (2009). Childbirth fear, anxiety, fatigue, and sleep deprivation in pregnant women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 38(5), 567-576.
18. Ham Jr, J. T., & Klimo, J. (2000). Fetal awareness of maternal emotional states during pregnancy. Journal of Prenatal & Perinatal Psychology & Health, 15(2), 118.
19. Huizink, A. C., Mulder, E. J., de Medina, P. G. R., Visser, G. H., & Buitelaar, J. K. (2004). Is pregnancy anxiety a distinctive syndrome? Early human development, 79(2), 81-91.
20. Kamali, A., Vaghee, S., Asgharipour, N., & Behnam vashani, H. R. (2016). The impact of Emotion Regulation Training on Mental health in Mothers of Children with attention deficit/hyperactivity Disorder. Journal of Torbat Heydariyeh University of Medical Sciences, 4(3), 16-23.
21. Karami, K., Mardani, A., ShakeriNejad, G., & Saki, A. (2015). Effectiveness of A Codified Educational Behavioral Program on the Mental Health of Pregnant Women. SSU_Journals, 23(9), 879-889.
22. Kingston, D., Janes-Kelley, S., Tyrrell, J., Clark, L., Hamza, D., Holmes, P., . . . Austin, M.-P. (2015). An integrated web-based mental health intervention of assessment-referral-care to reduce stress, anxiety, and depression in hospitalized pregnant women with medically high-risk pregnancies: a feasibility study protocol of hospital-based implementation. JMIR research protocols, 4(1).
23. Kohman, R. A., Tarr, A. J., Day, C. E., McLinden, K. A., & Boehm, G. W. (2008). Influence of prenatal stress on behavioral, endocrine, and cytokine responses to adulthood bacterial endotoxin exposure. Behavioural brain research, 193(2), 257-268.
Kugu, N., & Akyuz, G. (2001). Psychological state in pregnancy. Journal of the Faculty of Medicine Cumhuriyet University, 23(1), 61-64.
24. McCubbin, J. A. (2009). Prenatal maternal stress hormones, risk for hypertension, and the neonatal pain response: Comment on France et al.,“Maternal family history of hypertension attenuates neonatal pain response”. Pain, 142(3), 173.
25. Mehrabi A, T. Z., Mohamadi A. (2015). emotion regulation psychotherapy, Introduction to the Third Generation of Cognitive Behavioral Therapies. 150-155.
26. Melville, J. L., Gavin, A., Guo, Y., Fan, M.-Y., & Katon, W. J. (2010). Depressive disorders during pregnancy: prevalence and risk factors in a large urban sample. Obstetrics and gynecology, 116(5), 1064.
27. Mennin, D. S., Fresco, D. M., Ritter, M., & Heimberg, R. G. (2015). An open trial of emotion regulation therapy for generalized anxiety disorder and cooccurring depression. Depression and Anxiety, 32(8), 614-623.
28. Nesayan, A., Hosseini, B., & Asadi Gandomani, R. (2017). The Effectiveness of Emotion Regulation Skills Training on Anxiety and Emotional Regulation Strategies in Adolescent Students. Practice in Clinical Psychology, 5(4), 263-270.
29. Osman, A., Wong, J. L., Bagge, C. L., Freedenthal, S., Gutierrez, P. M., & Lozano, G. (2012). The depression anxiety stress Scales—21 (DASS‐21): further examination of dimensions, scale reliability, and correlates. Journal of clinical psychology, 68(12), 1322-1338.
30. Otley, H. (2011). Fear of childbirth: Understanding the causes, impact and treatment. British Journal of Midwifery, 19(4).
31. Pallarés, M. E., Bernasconi, P. A. S., Feleder, C., & Cutrera, R. A. (2007). Effects of prenatal stress on motor performance and anxiety behavior in Swiss mice. Physiology & behavior, 92(5), 951-956.
32. Parsons, C. E., Young, K. S., Rochat, T. J., Kringelbach, M., & Stein, A. (2012). Postnatal depression and its effects on child development: a review of evidence from low-and middle-income countries. British medical bulletin, 101(1).
33. Patel, V., Rahman, A., Jacob, K., & Hughes, M. (2004). Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia. BMJ: British Medical Journal, 328(7443), 820.
34. Seng, J. S., D'andrea, W., & Ford, J. D. (2014). Complex mental health sequelae of psychological trauma among women in prenatal care. Psychological Trauma: Theory, Research, Practice, and Policy, 6(1), 41.
35. Sherwen, L. N., Scoloveno, M. A., & Weingarten, C. T. (1995). Nursing care of the childbearing family: McGraw-Hill/Appleton & Lange.
36. Sobhi-Gharamaleki, N., Porzoor, P., Aghajani, S., & Narimani, M. (2015). Effectiveness of emotion regulation training on reduction of anxiety, stress and depression symptoms among University students. Iranian Journal of Health Education & Promotion, 3(1), 5.
37. Toosi, M., Akbarzadeh, M., Zare, N., & Sharif, F. (2011). Effect of attachment training on anxiety and attachment behaviors of first-time mothers. Journal of hayat, 17(3), 69-79.
38. Verreault, N., Da Costa, D., Marchand, A., Ireland, K., Dritsa, M., & Khalifé, S. (2014). Rates and risk factors associated with depressive symptoms during pregnancy and with postpartum onset. Journal of psychosomatic obstetrics & gynecology, 35(3), 84-91.
39. Wirtz, C. M., Hofmann, S. G., Riper, H., & Berking, M. (2014). Emotion regulation predicts anxiety over a five‐year interval: A cross‐lagged panel analysis. Depression and Anxiety, 31(1), 87-95.
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