Preterm premature rupture of the membranes (PPROM): a study of patient experiences and support needs.

Background: Preterm prelabour rupture of membranes (PPROM) is a common obstetric condition but outcomes can vary depending on gestation. Significant maternal and foetal complications occur including preterm birth, infection, abruption, cord prolapse, pulmonary hypoplasia and even death. Although the need for psychological support is recognised it is unclear how much is actually offered to women and their families.

Exposure-based cognitive-behaviour therapy for anxiety-related disorders in pregnancy (ADEPT): Results of a feasibility randomised controlled trial of time-intensive versus weekly CBT.

Background: Exposure-based cognitive-behaviour therapies (CBT) are effective but their acceptability in pregnancy is untested. Time-intensive delivery of CBT (INT-CBT) may accelerate treatment response. This feasibility trial aimed to explore this.

Patient and therapist experiences of exposure therapy for anxiety-related disorders in pregnancy: qualitative analysis of a feasibility trial of intensive versus weekly CBT.

Background: Approximately 15% of pregnant women experience anxiety disorders. Effective treatments exist but their acceptability during pregnancy, particularly exposure therapy, is not known.

Aims: To understand patient and therapist experiences of time-intensive and weekly exposure-based therapy for anxiety disorders delivered during pregnancy.

Paternal perinatal stress is associated with children's emotional problems at 2 years.

Background: Paternal mental health in pregnancy and postpartum has been increasingly highlighted as important both in its own right, but also as crucial for the development of children. Rates of help-seeking among fathers is low, possibly due to conceptualising their own difficulties as stress rather than problems with mood. The relationship between paternal stress and child outcomes has not been investigated.

Preventing anxiety in the children of anxious parents - feasibility of a brief, online, group intervention for parents of one- to three-year-olds.

Background: The evidence suggests an increased risk of developing anxiety problems in children of anxious parents. The current study explored the feasibility and acceptability of an intervention with anxious parents of young children, to inform the possibility of further trials.

Methods: Participants were recruited through primary and secondary care psychological services and social media.

Mental health service use among pregnant and early postpartum women.

Purpose: To explore the proportion and characteristics of women with a mental disorder who have contact with mental health services during pregnancy and the postnatal period in a maternity service in London.

Methods: Data from the WEll-being in pregNancy stuDY (WENDY), a prospective cohort study, were used. Women were recruited at their first appointment for antenatal care and assessed for mental disorders using the Structured Clinical Interview DSM-IV Axis I/II Disorders for Research.

Optimising psychological treatment for Anxiety DisordErs in Pregnancy (ADEPT): study protocol for a feasibility trial of time-intensive CBT versus weekly CBT.

Background: Moderate to severe anxiety disorders such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social phobia and panic disorder are common, and affect approximately 11-16% of women in pregnancy. Psychological treatments for anxiety disorders, primarily cognitive behaviour therapy (CBT), have a substantial evidence base and recently time-intensive versions have been found as effective as weekly treatments. However, this has not been trialled in women who are pregnant, where a shorter intervention may be desirable.

Fear of childbirth during pregnancy: associations with observed mother-infant interactions and perceived bonding.

Fear of childbirth (FOC) is a common phenomenon that can impair functioning in pregnancy but potential longer term implications for the mother-infant relationship are little understood. This study was aimed at investigating postpartum implications of FOC on the mother-infant relationship. A UK sample of 341 women in a community setting provided data on anxiety, mood and FOC in mid-pregnancy and subsequently completed self-report measures of postnatal bonding in a longitudinal cohort study.

The characteristics and prevalence of phobias in pregnancy.

Objective: The primary objective was to estimate the population prevalence of specific phobias (including pregnancy related specific phobias) and associated mental disorders. The secondary objective was to investigate the effectiveness of routinely collected screening tools (depression and anxiety screens, Whooley and GAD-2 respectively) in identifying specific phobias. Specific phobias are the most common anxiety disorder to occur during pregnancy, but studies on prevalence and clinical correlates of specific phobias, including pregnancy related specific phobias are lacking.

The association between prenatal maternal anxiety disorders and postpartum perceived and observed mother-infant relationship quality.

Introduction: Prenatal maternal anxiety disorders have been associated with adverse outcomes in offspring including emotional, behavioral and cognitive problems. There is limited understanding of the mechanisms underpinning these associations, although one possible candidate is an impaired mother-infant relationship. The authors investigated whether prenatal anxiety disorders were associated with poorer postpartum mother-infant relationship quality, measured by maternal self-reported bonding and observed mother-infant interactions.

Correlates and Predictors of New Mothers' Responses to Postpartum Thoughts of Accidental and Intentional Harm and Obsessive Compulsive Symptoms.

Background: Unwanted, intrusive thoughts of infant-related harm are a normal, albeit distressing experience for most new mothers. The occurrence of these thoughts can represent a risk factor for the development of obsessive compulsive disorder (OCD). As the early postpartum period represents a time of increased risk for OCD development, the transition to parenthood provides a unique opportunity to better understand OCD development.

Parenting and mother-infant interactions in the context of maternal postpartum obsessive-compulsive disorder: Effects of obsessional symptoms and mood.

Background: Maternal mental illness is associated with negative effects on the infant and child. Increased attention has been paid to the effects of specific perinatal disorders on parenting and interactions as an important mechanism of influence. OCD can be a debilitating disorder for the sufferer and those around them.

Context is Everything: An Investigation of Responsibility Beliefs and Interpretations and the Relationship with Obsessive-Compulsive Symptomatology across the Perinatal Period.

Background: The cognitive-behavioural model of perinatal OCD suggests the role of increased sense of responsibility during the perinatal period in the development and maintenance of obsessive-compulsive symptoms. However, the idiosyncratic nature of responsibility attitudes and interpretations of intrusions is not fully understood.

Aims: To investigate how responsibility interpretations regarding intrusions vary across the perinatal period and how this relates to obsessive-compulsive symptomatology.

Intensive cognitive-behavioural treatment for women with postnatal obsessive-compulsive disorder: a consecutive case series.

The postnatal period has been identified as a time of increased risk for the development of OCD. Obsessions and compulsions at this time frequently focus on accidental or deliberate harm coming to the infant and may impact on the sufferer's capacities as a parent. Given the similarities in presentation between OCD at this and other times, cognitive-behaviour therapy is likely to be effective, but there is little information on whether or how adaptations of CBT can be made to maximise effectiveness and acceptability for mothers.