Effects Of Brief Coping Training And A Gratitude Diary On Depression And Anxiety Symptoms In Pregnant Women

Objective:During pregnancy,women are vulnerable to developing psychological symptoms that could adversely affect the physiological and psychological health of both themselves and their babies.Our study group proposed two self-help psychological interventions that could guide women in correctly coping with emotional problems during pregnancy:brief coping training and a gratitude diary.The purposes of this study were(a)to examine the effectiveness of the brief coping training and gratitude diary for pregnant women with antenatal depressive or anxiety symptoms,and to compare their treatment effects;and(b)to investigate,via moderation analyses,for whom the brief coping training or gratitude diary work.Methods:Randomized controlled trial design.Participants were recruited between May 2016 and November 2016 through an obstetric outpatient clinic.Seventy-four women fulfilling the inclusion criteria were invited to participate in the study.Participants were randomly assigned to a brief coping training group(N = 37)and a gratitude diary group(N = 37),and they completed baseline demographic data collection and psychological assessment.After the four-week intervention,participants in both groups were asked to complete the questionnaire set again.The primary analysis compared the scores of the outcome variables at baseline and post-intervention using the paired t-test and chi-square test.The secondary analysis examined the potential moderators of the effect of the two interventions on depressive and anxiety symptoms.Results:(1)Both of the brief coping training and gratitude diary interventions significantly improved the depression and anxiety symptoms of pregnant women(both ps<0.01),and the brief coping training significantly improved women’s fatigue symptom(t = 2.926,p = 0.006).There were no significant differences between the two groups in the stress symptom.(2)The main effect of time on depression and anxiety was significant(both ps<0.01),and the main effect of group on fatigue was significant(p = 0.006).In addition,only a significant interaction of time x group emerged for fatigue(p = 0.011),revealing that the brief coping training group had a significant improvement in fatigue,whereas the gratitude diary group showed the opposite,as they already had a milder fatigue symptom at baseline.(3)The moderation analyses revealed that women who had experienced one or two pregnancies,with a low level of social support and a high level of rumination were more suitable for receiving the brief coping training to deal with depressive symptoms,while women experiencing more than three pregnancies,with a high level of social support and a low level of rumination were more suitable for receiving the gratitude diary.(4)The moderation analyses revealed that women with very bad sleep quality and a high level of social support were more suitable for receiving the gratitude diary to deal with anxiety symptoms,while women with relatively good sleep quality and a low level of social support were more suitable for receiving the brief coping training.Conclusions:(1)The results achieved in this study demonstrate that both of the brief self-help interventions can significantly improve the depression and anxiety symptoms of pregnant women,and the brief coping training significantly improved women’s fatigue symptom.(2)The moderation analyses revealed that the different levels of gravidity,social support,and rumination could significantly affect the treatment effect of the brief coping training and gratitude diary on antenatal depression,while the different levels of sleep quality and social support could significantly influence the treatment effect of the brief coping training and gratitude diary on antenatal anxiety.