(PS3-9) Effectiveness of Cognitive and Behavioral Therapy Skills: Findings from a Recent Meta-analytic Review of Psychosocial Interventions for Perinatal Depression

Friday, November 15, 2024

11:30 AM – 12:30 PM EST

Location: Franklin Hall, Level 4, Marriott Downtown

Author(s)

AS

Anisha Satish, M.A.

Ph.D. Student in Clinical Psychology
Rowan University
Glassboro, New Jersey, United States
AW

Allison Warner, M.S.

Ph.D. Student in Clinical Psychology
Rowan University
Glassboro, New Jersey, United States
Steven M. Brunwasser, Ph.D.

Assistant Professor
Rowan University
Glassboro, New Jersey, United States

Abstract Text:

Background: Depression is among the most common health complications affecting the perinatal period (pregnancy to first year postpartum). Perinatal depression is linked to numerous health complications in mothers and their children, including adverse obstetric outcomes, increased maternal suicidality, disruptions in parent-child bonding, and poorer child developmental outcomes. In this study, we evaluated the efficacy of cognitive-behavioral (CB) interventions in targeting perinatal depressive symptoms and tested whether effects of CB interventions differed from non-CB interventions. Both treatment and prevention trials were included.

Method: Randomized controlled trials (RCTs) published globally in 2021 and 2022 were analyzed. Intervention effects were quantified using Hedges’s g, representing the difference between control and intervention arms in standard deviation units. Robust variance estimation (RVE) was used to aggregate effect estimates across studies. RVE is advantageous in studies providing multiple relevant effect estimates because it allows for the calculation of pooled effects across statistically dependent estimates without compromising confidence interval coverage probabilities.

Results: The meta-analysis included 62 RCTs contributing 146 effect estimates. Twenty-one (33.9%) of the trials evaluated a CB intervention, with 12 evaluating CB alone and 9 combining CB with other strategies. Twelve trials overall (19.4%), including 4 evaluating CB interventions, were conducted in low or middle-income nations. CB interventions included traditional CB approaches (e.g., cognitive therapy) and third-wave interventions (e.g., acceptance and commitment therapy and dialectical behavior therapy). The weighted average effect size (g+) indicated that CB interventions reduced depressive symptoms by 0.43 standard deviations relative to control conditions (g+ = -0.43, 95% CI: [-0.80, -0.06]). Though CB was effective in both, effects tended to be larger in treatment (g+ = -0.75, 95% C [-1.13, -0.37]) than in prevention (g+ = -0.43, 95% C [-0.80, -0.06]) trials. There was no evidence that the mean effect of CB interventions differed from non-CB interventions (est = -0.05, 95% CI [-0.39, 0.28]). When evaluating the subset of trials that used CB interventions, there was no evidence that trials combining CB strategies with non-CB strategies (e.g., parenting and breastfeeding skills) differed in their mean effect relative to those using only CB strategies.

Conclusions: On average, CB interventions were effective in both prevention and treatment trials in targeting perinatal depressive symptoms. There was no evidence that trials using CB interventions differed in their intervention effects compared to trials using non-CB interventions.