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An open trial with cognitive behavioral therapy for blood- and injection phobia in pregnant women—a group intervention program

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Abstract

Around 7% of pregnant women suffer from blood- and injection phobia. The aim was to investigate if cognitive behavior group therapy (CBT) is effective in treating pregnant women’s blood- and injection phobia. Thirty pregnant women with blood- and injection phobia according to DSM-IV took part in an open treatment intervention. A two-session cognitive behavior group therapy was conducted. As controls, 46 pregnant women with untreated blood- and injection phobia and 70 healthy pregnant women were used. Repeated measures ANOVA were performed. The scores for the CBT treatment group on the “Injection Phobia Scale-Anxiety” were reduced both after each treatment session and postpartum (p < 0.001). Anxiety and depressive symptoms were also reduced (p < 0.001). Cognitive-behavior group therapy for pregnant women with blood- and injection phobia is effective and stable up to at least 3 months postpartum. It seems also to reduce anxiety and depressive symptoms during pregnancy.

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References

  • Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897

    Article  PubMed  CAS  Google Scholar 

  • Copper RL, Goldenberg RL, Das A, Elder N, Swain M, Norman G et al (1996) The preterm prediction study: maternal stress is associated with spontaneous preterm birth at less than thirty-five weeks’ gestation.National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol 175:1286–1292

    Article  PubMed  CAS  Google Scholar 

  • Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression: development of the 10-item Edinburgh Depression Scale. Br J Psychiatry 150:782–786

    Article  PubMed  CAS  Google Scholar 

  • Davey GCL, De Jong PJ, Tallis F (1993) UCS inflation in the aetiology of a variety of anxiety disorders: some case histories. Behav Res Ther 31:495–498

    Article  PubMed  CAS  Google Scholar 

  • Diego MA, Jones NA, Field T, Hernandez-Reif M, Schanberg S, Kuhn C et al (2006) Maternal psychological distress, prenatal cortisol and fetal weight. Psychosom Med 68:747–753

    Article  PubMed  Google Scholar 

  • DSM-IV: Diagnostic and Statistic Manual of Mental Disorders, fourth edition, American Psychiatric Association (1994)

  • Field T, Hernandez-Reif M, Diego M, Figueiredo B, Schanberg S, Kuhn C (2006) Prenatal cortisol, prematurity and low birthweight. Infant Behav Dev 29:268–275

    Article  PubMed  Google Scholar 

  • Gitau R, Cameron A, Fisk NM, Glover V (1998) Fetal exposure to maternal cortisol. The Lancet 352:707–708

    Article  CAS  Google Scholar 

  • Goisman RM, Allsworth J (1998) Simple phobia as a comorbid anxiety disorder. Depress Anxiety 7:105–112

    Article  PubMed  CAS  Google Scholar 

  • Green JM, Murray D (1994) The use of the Edinburgh postnatal depression scale in research to explore the relationship between antenatal and postnatal dysphoria. In: Cox J, Holden J (eds) Perinatal psychiatry: use and misuse of the Edinburgh postnatal depression scale. Gaskell, London, pp 180–198

    Google Scholar 

  • Hamilton JG (1995) (1995) Needle phobia: a neglected diagnosis. J Fam Pract 41:169–175

    PubMed  CAS  Google Scholar 

  • Heron J, O’Connor T (2004) The course of anxiety and depression through pregnancy and the postpartum in a community sample. J Affect Disord 80:65–73

    Article  PubMed  Google Scholar 

  • Hofberg K, Brockington I (2000) Tokophobia: an unreasoning dread of childbirth: a series of 26 cases. Br J Psychiatry 176:83–85

    Article  PubMed  CAS  Google Scholar 

  • Josefsson A, Berg G, Nordin C, Sydsjö G (2001) Prevlence of depressive symptoms in late pregnancy and postpartum. Acta Obstet Gynecol Scand 80:251–255

    PubMed  CAS  Google Scholar 

  • Kessler RC, Chiu WT, Demler O, Walters EE (2005) Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:617–625

    Article  PubMed  Google Scholar 

  • Kose S, Mandiracioglu A (2007) Fear of blood/injection in healthy and unhealthy adults admitted to a teaching hospital. Int J Clin Pract 61:453–457

    Article  PubMed  CAS  Google Scholar 

  • Lilliecreutz C, Josefsson A (2008) Prevalence of blood and injection phobia among pregnant women. Acta Obstet Gynecol Scand 87:1276–1279

    Article  PubMed  Google Scholar 

  • Menzies RG, Clark JC (1995) The aetiology of phobias: a non-associative account. Clin Psychol Rev 1:23–48

    Article  Google Scholar 

  • Nir Y, Paz A, Sabo E, Potasman I (2003) Fear of injections in young adults: prevalence and associations. Am J Trop Med Hyg 68:341–344

    PubMed  Google Scholar 

  • Obel C, Hedegaard M, Henriksen TB, Secher NJ, Olsen J, Levine S (2005) Stress and salivary cortisol during pregnancy. Psychoneuroendocrinology 30:647–656

    Article  PubMed  CAS  Google Scholar 

  • Olatunji BO, Williams NL, Sawchuk CN, Lohr JM (2006) Disgust, anxiety and fainting symptoms associated with blood-injection-injury fears: a structural model. J Anxiety Disord 20:23–41

    Article  PubMed  Google Scholar 

  • Öst L (1992) Blood and Injection Phobia. Background and cognitive, physiological and behavioral variables. J Abnorm Psychol 101:68–74

    Article  PubMed  Google Scholar 

  • Öst L, Hellström K, Kåver A (1992) One versus five sessions of exposure in the treatment of injection phobia. Behavior Theraphy 23:263–282

    Article  Google Scholar 

  • Page AC (1996) Blood-injury-injection fears in medical practice. Med J Aust 164:189

    PubMed  CAS  Google Scholar 

  • Patel MX, Baker D, Nosarti C (2005) Injection phobia: a systematic review of psychological treatments. Behav Cogn Psychother 33:343–349

    Article  Google Scholar 

  • Sandman CA, Wadhwa PD, Dunkel-Schetter C, Chicz-DeMat A, Belman J, Porto M et al (1994) Psychobiological influences of stress and HPA regulation on the human fetus and infant birth outcomes. Ann N Y Acad Sci 739:198–210

    Article  PubMed  CAS  Google Scholar 

  • Sutter-Dally 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 19:459–463

    Article  Google Scholar 

  • Wadhwa PD, Sandman CA, Porto M, Dunkel-Schetter C, Garite TJ (1993) The association between prenatal stress and infant birth weight and gestational age at birth: a prospective investigation. Am J Obstet Gynecol 169:858–865

    Google Scholar 

  • Weinstock M (2005) The potential influence of maternal stress hormones on development and mental health of the offspring. Brain Behav Immun 19:296–308

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by grants from The Health Research Council in the South East of Sweden. We thank midwives I. Andersson and B. Ljungberg for perfect assistance.

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Correspondence to Caroline Lilliecreutz.

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Lilliecreutz, C., Josefsson, A. & Sydsjö, G. An open trial with cognitive behavioral therapy for blood- and injection phobia in pregnant women—a group intervention program. Arch Womens Ment Health 13, 259–265 (2010). https://doi.org/10.1007/s00737-009-0126-x

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  • DOI: https://doi.org/10.1007/s00737-009-0126-x

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