Psychological distress is common during pregnancy. The objective of this thesis was to evaluate the effectiveness of antenatal cognitive behavioural based treatments in reducing psychological distress in pregnant women. A systematic review was undertaken of randomised controlled studies utilizing antenatal cognitive behavioural based treatment in reducing anxiety and stress compared to treatment as usual. Eleven papers were identified through a systematic search of databases using predefined criteria comparing intervention groups to treatment as usual in pregnant women with anxiety or stress. The systematic review revealed preliminary evidence for the effectiveness of cognitive behavioural based treatment with several studies noting changes over time in anxiety and stress; however, only a few studies reported intervention effects when compared to control. While the systematic review results suggest that a small number of cognitive behavioural based interventions may be effective in reducing anxiety and stress during pregnancy compared to treatment as usual, confidence in these findings is limited due to methodological limitations such as lack of follow-up, high attrition rates and difficulties with generalisability. The evidence base is currently insufficient and further research which utilises a robust methodology is needed before any reliable conclusions can be drawn. An empirical study was conducted to examine the effectiveness of a brief, single-session stress reduction programme introducing cognitive behavioural techniques aimed at reducing general anxiety, other pregnancy related distress and improving general well-being and pregnancy outcomes. Twenty-nine participants with clinically significant levels of anxiety were recruited to the empirical study from the local maternity hospital. Participants completed measures of general anxiety, pregnancy related anxiety, general well-being and childbirth experience. The control was derived from a historical dataset where 37 participants were matched for baseline anxiety levels. The empirical study demonstrated significant reductions in general anxiety; however, similar findings were also observed in the control group. Significant reductions were observed with pregnancy related anxiety and women also reported their childbirth experience similarly regardless of delivery type. Although our findings were not significant when compared to control, our recruitment design resulted in good return rates following birth. Further studies using sophisticated study design with use of robust control group are required.

Background: Maternal mental health during pregnancy and its effects on offspring outcomes have received increased attention as a public health concern. This thesis aimed to examine and evaluate current research into the long term effects of maternal antenatal anxiety on offspring’s psychological development and markers of developmental psychopathology. This thesis also aimed to identify protective factors to parental distress during pregnancy. Self-compassion and adult attachment security have been found to be protective psychological factors for ameliorating stress in general adult samples. Therefore the empirical paper aimed to investigate the effect of these factors during the antenatal period. Method: A systematic literature review of prospective studies examining the effects of maternal antenatal anxiety on child psychopathology and neurodevelopment literature identified 16 relevant prospective studies. The empirical study recruited a general population sample of women and their partners during their second trimester of pregnancy. They completed self-report assessments of self-compassion, adult attachment security, mood and antenatal attachment. Neonatal birth outcome data was collected as follow-up data. Results: The systematic literature review results indicate that maternal antenatal anxiety can be measured and does have a negative impact on offspring development. The results also identified a broad risk phenotype, suggesting that interventions should not necessarily only be targeted at women reaching clinical caseness. The review highlighted a lack of specificity regarding possible psychological mechanisms of the relationship between maternal antenatal anxiety and offspring outcomes. The results of the empirical paper indicated that higher levels of self-compassion and attachment security were related to fewer self-reported symptoms of distress in mothers and their partners. Self-compassion was found to mediate the relationship between attachment security and distress in mothers. Neither antenatal attachment nor neonatal birth outcomes were significantly related to attachment security, self-compassion or levels of distress. Conclusions: The results of the systematic review should broaden public health concern. A need for future research is identified in terms of understanding the process of maternal-foetal programming, protective mediating factors and effective interventions. The role of self-compassion as a protective mediating factor is discussed in relation to identification and treatment of distress during the antenatal period.

Tyrimo tikslas – nustatyti nėščiųjų su gimdymu susijusio saviveiksmingumo, nėštumo nerimo ir sveikatos rodiklių sąsajas. Tyrime dalyvavo 146 Šiaulių rajono gyventojos (moterys), kurioms buvo pateikiamos tyrimo anketos prieš ar per vizitą pas gydytoją. Tiriamosios užtruko apie 20 pildydamos tyrimo anketą. Siekiant įvertinti su gimdymu susijusį saviveiksmingumą, buvo pateikta gimdymo saviveiksmingumo vertinimo skalė; siekiant įvertinti nėštumo nerimą, buvo pateikta nėštumui specifiško nerimo skalė; siekiant įvertinti nėštumo komplikacijas, buvo pateikta komplikacijų nustatymo skalė; siekiant nustatyti miego kokybę, fizinio aktyvumo lygį ir sveikatai nepalankų elgesį, buvo pateiktos atitinkamos vertinimo skalės. Tyrimo rezultatai parodė, kad nėštumo nerimas didėja, mažėjant su gimdymu susijusiam saviveiksmingumui. Didėjant su gimdymu susijusiam saviveiksmingumui, nustatytų komplikacijų skaičius mažėja, be to, gimdymo saviveiksmingumas yra mažesnis, jei nustatomos šios nėštumo komplikacijos: ”inkstų ir šlapimo takų infekcija”, “pilvo ir strėnų skausmai”, “pykinimas”, “vėmimas”. Didesnis saviveiksmingumo skalės vidurkis nustatytas toje nėščiųjų imtyje, kurių fizinis aktyvumas darbo (ar kitos dienos veiklos) metu yra didesnis bei toje nėščiųjų imtyje, kurios dažniau atlikdavo įvairius jėgos lavinimo pratimus ištvermės ugdymui. Didėjant su gimdymu susijęs saviveiksmingumui, miego kokybė taip pat didėja. Saviveiksmingumas yra didesnis tų nėščiųjų, kurios nėštumo metu nerūkė... [toliau žr. visą tekstą] / The aim of the study was to assess the associations between pregnancy self-efficacy, pregnancy anxiety and health indexs. The subjects of the study were 146 pregnant women, Šiaulių rajonas residents. They were asked to complete a questionnaire; the completion of it took about 20 min. The participats were asked about various aspects related to pregnancy. In order to evalute pregnancy self-efficacy, pregnancy self-efficay scale was given; in order to esstimate pregnancy anxiety, pregnancy specific anxiety scale was given; in order to eveluate pregnancy complications, questions about specific pregnancy outcomes were asked; in order to esstimate sleep quality, physical activity level and unflavuorable to health behavior, questions about these aspects were given respectively. The results of the study showed that pregnancy specific anxiety declines, when pregnancy self-efficacy enlarges. The increscent of self-efficacy is associated with decline of pregnancy complications. Moreover, lower self-efficacy is associated with these pregnancy complications: „the infection of kidney“, „pelvic pain”, ”nausea” and ”vomiting”. Major mean of pregnancy self-efficacy scale was identified in the contingent of those pregnant women, whose physical activity leveles were bigger. Futhermore, the increscent of self-efficacy is associated with better sleep quality. Major mean of pregnancy self-efficacy scale was indentified in the contingent of those pregnant women, who didn’t smoke during... [to full text]