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A Brief Intervention for the Treatment of Anxiety in Pregnancy: A Pilot Randomized Controlled Trial (The TAP Study)
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DOI：10.1159/000551731.png)
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Abstract
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Introduction: Anxiety during pregnancy affects 1 in 4 pregnancies and is often comorbid with other mental health disorders. Early intervention is crucial to avoid persistent mental health issues and adverse obstetrical, neonatal and child outcomes. Traditional mindfulness-based cognitive therapy is effective, but its uptake is limited by its high resource intensity for patients and healthcare services. This study investigated the feasibility, acceptability, and preliminary efficacy of a novel, brief psychotherapy, mindful adaptive practice in pregnancy (MAPP), delivered in a synchronous virtual group format. Methods: This pilot randomized controlled trial (RCT) was conducted at two university-affiliated health centers. Pregnant persons with elevated anxiety symptoms were randomly assigned to MAPP plus treatment as usual (TAU) or TAU alone. MAPP was delivered in five, 2-h virtual group sessions, over 4 weeks. Feasibility was assessed by recruitment rates and participant eligibility, intervention acceptability through online questionnaires, and adherence by session attendance and follow-up completion. Efficacy was preliminarily evaluated by anxiety symptom change post-treatment. Results: Participants were recruited from November 2021 to May 2022, with 69 randomized to MAPP (36 participants) or TAU (33 participants). High acceptability and adherence were reported for MAPP with over 80% attending three or more sessions. Preliminary results suggest significant reduction in anxiety symptoms for participants receiving MAPP compared to TAU. Conclusion: MAPP was feasible and well accepted. Preliminary data suggest that this brief, synchronous virtual therapy may effectively reduce anxiety symptoms. Further investigation into MAPP's efficacy in a larger-scale RCT can confirm its viability as an intervention for anxiety during pregnancy. Anxiety is common during pregnancy and it is important to identify and treat people with high anxiety to prevent ongoing mental health or other problems including with baby. Traditional psychotherapy reduces anxiety but it takes a long time to learn. This study examined the research plan assessing a new brief treatment called mindful adaptive practice in pregnancy (MAPP). Specifically, it assessed whether the plan was feasible, acceptable, if people would adhere to it and whether the treatment could reduce anxiety. This initial randomized controlled trial (RCT) was completed at 2 university health centers. Pregnant persons with anxiety symptoms were randomly put into the MAPP group (and usual care) or the usual care group alone. MAPP was made up of five sessions and each delivered within 2-h over the internet in a group format within 4 weeks. Measures of feasibility, acceptability and adherence were taken. Questionnaires assessed if MAPP reduced anxiety symptoms after treatment. A total of 69 people were randomly allotted to the MAPP (36 participants) or usual care (33 participants) group. People signed up for the study fairly quickly, rated the therapy highly, and attended sessions mostly as expected. Initial findings also showed MAPP did reduce anxiety symptoms more than usual care did. This study showed that the plan to study the new treatment called MAPP is feasible, well accepted, and can be followed by people. Early results showed MAPP can reduce anxiety. Future research needs to confirm MAPP is a good treatment option for persons with anxiety during pregnancy.
Keywords:
Anxiety
Mindfulness
Psychotherapy
Pregnancy
Virtual therapy
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