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01-10-2014 | Original Article

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

Authors: Janice H. Goodman, Anthony Guarino, Kerry Chenausky, Lauri Klein, Joanna Prager, Rebecca Petersen, Avery Forget, Marlene Freeman

Published in: Archives of Women's Mental Health | Issue 5/2014

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.

Adewuya AO, Ola BA, Aloba OO, Mapayi BM (2006) Anxiety disorders among Nigerian women in late pregnancy: a controlled study. Arch Women Ment Health 9:325–328CrossRef

Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W (2007) Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med 20:189–209PubMedCrossRef

Alvik A, Heyerdahl S, Haldorsen T, Lindemann R (2006) Alcohol use before and during pregnancy: a population-based study. Acta Obstet Gynecol Scand 85:1292–1298PubMedCrossRef

American Psychiatric Association (2004) Diagnostic and Statistical Manual of Mental Disorders (4th ed, text rev). American Psychiatric Publishing, Washington, DC

Andersson L, Sundström-Poromaa I, Wulff M, Åström M, Bixo M (2004) Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol 104:467–476PubMedCrossRef

Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M (2006) Depression and anxiety during pregnancy and six months postpartum: a follow-up study. Acta Obstetricia et Gynecologica 85:937–944CrossRef

Arch JJ, Ayers CR, Baker A, Almklov E, Dean DJ, Craske MG (2013) Randomized clinical trial of adapted mindfulness-based stress reduction versus group cognitive behavioral therapy for heterogeneous anxiety disorders. Behav Res Ther 51:185–196PubMedCrossRef

Bardacke N (2012) Mindful birthing: training the mind, body, and heart for childbirth and beyond. Harper One, New York

Beck AT, Steer RA (1990) Manual for the Beck Anxiety Inventory. The Psychological Corporation, San Antonio

Beck AT, Steer RA, Brown GK (1996) BDI-II: 2nd Edition Manual. The Psychological Corporation, San Antonio

Behar E, DiMarco ID, Hekler EB, Mohlman J, Staples AM (2009) Current theoretical models of generalized anxiety disorder (GAD): conceptual review and treatment implications. J Anxiety Disord 23:1011–1023PubMedCrossRef

Bogels SM, Lehtonen A, Restifo K (2010) Mindful parenting in mental health care. Mindfulness 1:107–120PubMedCrossRefPubMedCentral

Borkovec TD, Costello E (1993) Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. J Consult Clin Psychol 61:611–619PubMedCrossRef

Borri C, Mauri M, Oppo A, Banti S, Rambelli C, Ramacciotti D, Montagnani MS, Camilleri V, Cortopassi S, Bettini A, Ricciardulli S, Rucci P, Montaresi S, Cassano GB (2008) Axis I psychopathology and functional impairment at the third month of pregnancy: results from the Perinatal Depression-Research and Screening Unit (PND-ReScU) Study. J Clin Psychiatry 69:1617PubMedCrossRef

Britton JR (2008) Maternal anxiety: course and antecedents during the early postpartum period. Depress Anxiety 25:793–800PubMedCrossRef

Brown TA, Antony MM, Barlow DH (1992) Psychometric properties of the Penn State Worry Questionnaire in a clinical anxiety disorders sample. Behav Res Ther 30:33–37

Brown KW, Ryan RM (2003) The benefits of being present: the role of mindfulness in psychological well-being. J Pers Soc Psychol 84:822–848

Chiesa A, Serretti A (2009) Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med 15:593–600PubMedCrossRef

Chiesa A, Serretti A (2011) Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Res 187:441–453PubMedCrossRef

Coelho HF, Murray L, Royal-Lawson M, Cooper PJ (2011) Antenatal anxiety disorder as a predictor of postnatal depression: a longitudinal study. J Affect Disord 129:348–353PubMedCrossRef

Coleman VH, Carter MM, Morgan MA, Schulkin J (2008) United States obstetrician–gynecologists’ accuracy in the simulation of diagnosing anxiety disorders and depression during pregnancy. J Psychosom Obstet Gynecol 29:173–184

Craigie MA, Rees CS, Marsh A, Nathan P (2008) Mindfulness-based cognitive therapy for generalized anxiety disorder: a preliminary evaluation. Behav Cog Psychother 36:553–568CrossRef

Davis D, Hayes J (2011) What are the benefits of mindfulness? A practice review of psychotherapy‐related research. Psychotherapy 48(2):198–208

Duncan LG, Bardacke N (2010) Mindfulness-based childbirth and parenting education: promoting family mindfulness during the perinatal period. J Child Fam Stud 19:190–202PubMedCrossRefPubMedCentral

Duncan LG, Coatsworth JD, Greenberg MT (2009) A model of mindful parenting: implications for parent–child relationships and prevention research. Clin Child Fam Psychol Rev 12:255–270PubMedCrossRefPubMedCentral

Dunkel Schetter C, Tanner L (2012) Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry 25:141–148PubMedCrossRef

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. Arch Women Ment Health 15:139–143CrossRef

Evans J, Heron J, Francomb H, Oke S, Golding J (2001) Cohort study of depressed mood during pregnancy and after childbirth. Br Med J 323:257–260CrossRef

Evans S, Ferrando S, Findler M, Stowell C, Smart C, Haglin D (2008) Mindfulness-based cognitive therapy for generalized anxiety disorder. J Anxiety Disord 22:716–721PubMedCrossRef

Faisal-Cury A, Menezes PR (2007) Prevalence of anxiety and depression during pregnancy in a private setting sample. Arch Women Ment Health 10:25–32CrossRef

Farchione TJ, Fairholme CP, Ellard KK, Boisseau CL, Thompson-Hollands J, Carl JR, Gallagher MW, Barlow DH (2012) Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther 43(3):666–678PubMedCrossRefPubMedCentral

Fjorback LO, Arendt M, Ørnbøl E, Fink P, Walach H (2011) Mindfulness-based stress reduction and mindfulness-based cognitive therapy—a systematic review of randomized controlled trials. Acta Psychiatr Scand 124:102PubMedCrossRef

Garfinkle E, Behar E (2012) Advances in psychotherapy for generalized anxiety disorder. Curr Psychiatry Rep 12:203–210CrossRef

Germer CK (2012) Cultivating compassion in psychotherapy. In: Germer CK, Siegal RD (eds) Wisdom and compassion in psychotherapy: deepening mindfulness in clinical practice. Guilford, New York, pp 93–110

Giardinelli L, Innocenti A, Benni L, Stefanini M, Lino G, Lunardi C, Svelto V, Afshar S, Bovani R, Castellini G, Faravelli C (2012) Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample. Arch Women Ment Health 15:21–30CrossRef

Glover V, O’Connor T (2006) Maternal anxiety: its effect on the fetus and the child. Br J Midwifery 14:663–667CrossRef

Goodman JH (2009) Women’s attitudes, preferences, and perceived barriers to treatment for perinatal depression. Birth 36:60–69PubMedCrossRef

Goodman JH, Tyer-Viola L (2010) Detection, treatment, and referral of perinatal depression and anxiety by obstetrical providers. J Womens Health (Larchmt) 19:477–490CrossRef

Goodwin RD, Keyes K, Simuro N (2007) Mental disorders and nicotine dependence among pregnant women in the United States. Obstet Gynecol 109:875–883PubMedCrossRef

Greeson J, Brantley J (2009) Mindfulness and anxiety disorders: developing a wise relationship with the inner experience of fear. In: Didonna F (ed) Clinical handbook of mindfulness. Springer, New York, pp 171–187CrossRef

Grigoriadis S, de Camps MD, Barrons E, Bradley L, Eady A, Fishell A, Mamisachvili L, Cook GS, O’Keefe M, Romans S, Ross LE (2011) Mood and anxiety disorders in a sample of Canadian perinatal women referred for psychiatric care. Arch Womens Ment Health 14:325–333PubMedCrossRef

Grossman P, Niemann L, Schmidt S, Walach H (2004) Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res 57:35–43PubMedCrossRef

Hayes SC, Strosahl K, Wilson KG (1999) Acceptance and commitment therapy: an experiential approach to behavior change. Guilford, New York

Hayes RM, Wu P, Shelton RC, Cooper WO, Dupont WD, Mitchel E, Hartert TV (2012) Maternal antidepressant use and adverse outcomes: a cohort study of 228,876 pregnancies. Am J Obstet Gynecol 207:49e1–49e9CrossRef

Hayes-Skelton SA, Roemer L, Orsillo SM (2013) A randomized clinical trial comparing an acceptance-based behavior therapy to applied relaxation for generalized anxiety disorder. J Consult Clin Psychol 81(5):761–773PubMedCrossRef

Heeren A, Philippot P (2011) Changes in ruminative thinking mediate the clinical benefits of mindfulness: preliminary findings. Mindfulness 2:8–13

Heron J, O’Connor TG, Evans J, Golding J, Glover V (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73PubMedCrossRef

Hofmann SG, Sawyer AT, Witt AA, Oh D (2010) The effect of mindfulness-based therapy on anxiety and depression: a meta-analytic review. J Consult Clin Psychol 78:169–183PubMedCrossRefPubMedCentral

Hoge EA, Bui E, Marques L, Metcalf CA, Morris LK, Robinaugh DJ, Worthington JJ, Pollack MH, Simon NM (2013) Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. J Clin Psychiatry 74(8):786–792, March 13 Epub ahead of printPubMedCrossRefPubMedCentral

Hurley KM, Caulfield LE, Sacco LM, Costigan KA, Dipietro JA (2005) Psychosocial influences in dietary patterns during pregnancy. J Am Diet Assoc 105:963–966PubMedCrossRef

Jacobson NS, Truax P (1991) Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 59:12–19PubMedCrossRef

Kabat-Zinn J (1990) Full catastrophe living: using the wisdom of your body and mind to face stress, pain and illness. Bantam Dell, New York

Kabat-Zinn J, Massion AO, Kristeller J, Peterson LG, Fletcher KE, Pbert L, Lenderking WR, Santorelli SF (1992) Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry 149:936–943PubMed

Karsten J, Nolen WA, Penninx B, Hartman CA (2011) Subthreshold anxiety better defined by symptom self-report than by diagnostic interview. J Affect Disord 129:236–243PubMedCrossRef

Keng S, Smoski MJ, Robins CJ (2011) Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev 31:1041–1056PubMedCrossRefPubMedCentral

Kessler RC, Mcgonagle KA, Zhao S et al (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 51:8–19PubMedCrossRef

Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602PubMedCrossRef

Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V, Chapleau MA, Paquin K, Hofmann SG (2013) Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev 33:763–771PubMedCrossRef

Kim YW, Lee SH, Choi TK, Suh SY, Kim B, Kim CM, Cho SJ, Kim MJ, Yook K, Ryu M, Song SK, Yook KH (2009) Effectiveness of mindfulness-based cognitive therapy as an adjuvant to pharmacotherapy in patients with panic disorder or generalized anxiety disorder. Dep Anxiety 26:601–606CrossRef

Koszycki D, Benger M, Shlik J, Bradwejn J (2007) Randomized trial of a meditation-based stress reduction program and cognitive behavior therapy in generalized social anxiety disorder. Behav Res Ther 45:2518–2526PubMedCrossRef

Kroenke K, Spitzer RL, Williams JBW, Kroenke K, Spitzer RL, Williams JBW (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613PubMedCrossRefPubMedCentral

Kroenke K, Spitzer RL, Williams JBW, Monahan PO, Löwe B (2007) Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 146:317–W77PubMedCrossRef

Kuyken W, Watkins E, Holden E, White K, Taylor RS, Byford S, Evans A, Radford S, Teasdale JD, Dalgleish T (2010) How does mindfulness-based cognitive therapy work? Behav Res Ther 48:1105–1112PubMedCrossRef

Lee AM, Lam SK, Sze Mun Lau SM, Chong CS, Chui HW, Fong DY (2007) Prevalence, course, and risk factors for antenatal anxiety and depression. Obstet Gynecol 110:1102–1112PubMedCrossRef

Lecrubier Y, Sheehan DV, Weiller E, Amorim P, Bonora I, Harnett Sheehan K, Janavs J, Dunbar GC (1997) The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 12:224–231

Majid SA, Seghatoleslam T, Homan HA, Akhvast A, Habil H (2010) Effect of mindfulness based stress management on reduction of generalized anxiety disorder. Iran J Publ Health 41:24–28

Mauri M, Oppo A, Montagnani MS, Borri C, Banti S, Camilleri V, Cortopassi S, Ramacciotti D, Rambelli C, Cassano GB (2010) Beyond “postpartum depressions”: specific anxiety diagnoses during pregnancy predict different outcomes: results from PND-ReScU. J Affect Disord 127:177–184PubMedCrossRef

Mennin DS, Heimberg RG, Turk CL, Fresco DM (2005) Preliminary evidence for an emotion dysregulation model of generalized anxiety disorder. Behav Res Ther 43:1281–1310PubMedCrossRef

Meyer TJ, Miller ML, Metzger RL, Borkovec TD (1990) Development and validation of the Penn State Worry Questionnaire. Behav Res Ther 28:487–495PubMedCrossRef

Michalak J, Holz A, Teismann T (2011) Rumination as a predictor of relapse in mindfulness-based cognitive therapy for depression. Psychol Psychother 84:230–236PubMedCrossRef

Miller JJ, Fletcher K, Kabat-Zinn J (1995) Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. Gen Hosp Psychiatry 17:192–200PubMedCrossRef

Mota N, Cox BJ, Enns MW, Calhoun L, Sareen J (2008) The relationship between mental disorders, quality of life, and pregnancy: findings from a nationally representative sample. J Affect Disord 109:300–304PubMedCrossRef

Neff KD (2003) The development and validation of a scale to measure self-compassion. Self Identity 2:223CrossRef

Neff KD (2012) The science of self-compassion. In: Germer CK, Siegel RD (eds) Wisdom and compassion in psychotherapy: deepening mindfulness in clinical practice. Guilford, New York, pp 79–92

Norton PJ, Barrera TL (2012) Transdiagnostic versus diagnosis-specific CBT for anxiety disorders: a preliminary randomized controlled noninferiority trial. Depress Anxiety 29(10):874–882PubMedCrossRefPubMedCentral

Orsillo SM, Roemer L (2011) The mindful way through anxiety. Guilford, New York

Otte C (2011) Cognitive behavioral therapy in anxiety disorders: current state of the evidence. Dialogues Clin Neurosci 13:413–421PubMedPubMedCentral

Roemer L, Orsillo SM (2002) Expanding our conceptualization of and treatment for generalized anxiety disorder: integrating mindfulness/acceptance-based approaches with existing cognitive-behavioral models. Clin Psychol Sci Pract 9:54–68CrossRef

Roemer L, Orsillo SM (2007) An open trial of an acceptance-based behavior therapy for generalized anxiety disorder. Behav Ther 38:72–85PubMedCrossRef

Roemer L, Orsillo SM, Salters-Pedneault K (2008) Efficacy of an acceptance-based behavior therapy for generalized anxiety disorder: evaluation in a randomized controlled trial. J Consult Clin Psychol 76:1083–1089PubMedCrossRefPubMedCentral

Ross LE, McLean LM (2006) Anxiety disorders during pregnancy and the postpartum period: a systematic review. J Clin Psychiatry 67:1285–1298PubMedCrossRef

Sandelowski M (2000) Whatever happened to qualitative description? Res Nurs Health 23:246–255PubMedCrossRef

Segal ZV, Williams JM, Teasdale JD (2002) Mindfulness-based cognitive therapy for depression. Guilford, New York

Segal ZV, Williams JM, Teasdale JD (2013) Mindfulness-based cognitive therapy for depression second edition. Guilford, New York

Sheehan DV, Lecrubier Y, Harnett-Sheenhan K, Janavs J, Weiller E, Bonora LI, Keskiner A, Schinka J, Knapp E, Sheehan MF, Dunbar GC (1997) Reliability and validity of the MINI International Neuropsychiatric Interview (M.I.N.I.): according to the SCID-P. Eur Psychiatry 12:224–241CrossRef

Sipe WEB, Eisendrath SJ (2012) Mindfulness-based cognitive therapy: theory and practice. Can J Psychiatry 57:63–69PubMed

Somers JM, Goldner EM, Waraich P, Hsu L (2006) Prevalence and incidence studies of anxiety disorders: a systematic review of the literature. Can J Psychiatry 51:100–113PubMed

Spitzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J (2000) Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric–gynecologic patients: the PRIME-MD Patient Health Questionnaire obstetrics–gynecology study. Obstet Gynecol 183:759–769CrossRef

Spitzer RL, Kroenke K, Williams J, Lowe B (2006) A brief measure for assessing generalized anxiety disorder—The GAD-7. Arch Intern Med 166:1092–1097PubMedCrossRef

Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H (2004) Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiatry 19:459–463PubMedCrossRef

Swallow BL, Lindow SW, Masson EA, Hay DM (2004) Psychological health in early pregnancy: relationship with nausea and vomiting. J Obstet Gynaecol 24:28–32PubMedCrossRef

Teixeira J, Fisk NM, Glover V (1999) Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study. BMJ 318:153–157PubMedCrossRefPubMedCentral

Toneatto T, Nguyen L (2007) Does mindfulness meditation improve anxiety and mood symptoms? A review of the controlled research. Can J Psychiatry 52:260–266PubMed

Treanor M, Erisman SM, Salters-Pedneault K, Roemer L, Orsillo SM (2011) Acceptance-based behavioral therapy for GAD: effects on outcomes from three theoretical models. Depress Anxiety 28:127–136PubMedCrossRefPubMedCentral

Tull MT, Stipelman BA, Salters-Pedneault K, Gratz KL (2009) An examination of recent non-clinical panic attacks, panic disorder, anxiety sensitivity, and emotion regulation difficulties in the prediction of generalized anxiety disorder in an analogue sample. J Anxiety Disord 23:275–282PubMedCrossRef

Udechuku A, Nguyen T, Hill R, Szego K (2010) Antidepressants in pregnancy: a systematic review. Aust NZ J Psychiatry 44:978–996

Uguz F, Gezginc K, Kayhan F, Sari S, Buyukoz D (2010) Is pregnancy associated with mood and anxiety disorders? A cross-sectional study. Gen Hosp Psychiatry 32:213–215PubMedCrossRef

Van Dam N, Sheppard SC, Forsyth JP, Earleywine M (2011) Self-compassion is a better predictor than mindfulness of symptom severity and quality of life in mixed anxiety and depression. J Anxiety Disord 25:123–130PubMedCrossRef

Van den Bergh BR, Van Calster B, Smits T, Van Huffel S, Lagae L (2007) Antenatal maternal anxiety is related to HPA-axis dysregulation and self-reported depressive symptoms in adolescence: a prospective study on the fetal origins of depressed mood. Neuropsychopharmacology 33:536–545PubMedCrossRef

Vieten C, Astin J (2008) Effects of a mindfulness-based intervention during pregnancy on prenatal stress and mood: results of a pilot study. Arch Womens Ment Health 11:67–74PubMedCrossRef

Vollestad J, Sivertsen B, Nielsen GH (2011) Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial. Behav Res Ther 49:281–288PubMedCrossRef

Wenzel A (2011) Anxiety in childbearing women: diagnosis and treatment. American Psychological Association, Washington, DCCrossRef

Wilamowska ZA, Thompson-Hollands J, Fairholme CP, Ellard KK, Farchione TJ, Barlow DH (2010) Conceptual background, development, and preliminary data from the unified protocol for transdiagnostic treatment of emotional disorders. Depress Anxiety 27(10):882–890PubMedCrossRef

Zar M, Wijma K, Wijma B (2002) Relations between anxiety disorders and fear of childbirth during late pregnancy. Clin Psychol Psychot 9:122–130CrossRef

Title: CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety
Authors: Janice H. Goodman
Anthony Guarino
Kerry Chenausky
Lauri Klein
Joanna Prager
Rebecca Petersen
Avery Forget
Marlene Freeman
Publication date: 01-10-2014
Publisher: Springer Vienna
Published in: Archives of Women's Mental Health / Issue 5/2014
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI: https://doi.org/10.1007/s00737-013-0402-7

At a glance: The STEP trials

Springer Medicine

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

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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