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
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
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
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
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
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
Gitau R, Cameron A, Fisk NM, Glover V (1998) Fetal exposure to maternal cortisol. The Lancet 352:707–708
Goisman RM, Allsworth J (1998) Simple phobia as a comorbid anxiety disorder. Depress Anxiety 7:105–112
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
Hamilton JG (1995) (1995) Needle phobia: a neglected diagnosis. J Fam Pract 41:169–175
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
Hofberg K, Brockington I (2000) Tokophobia: an unreasoning dread of childbirth: a series of 26 cases. Br J Psychiatry 176:83–85
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
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
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
Lilliecreutz C, Josefsson A (2008) Prevalence of blood and injection phobia among pregnant women. Acta Obstet Gynecol Scand 87:1276–1279
Menzies RG, Clark JC (1995) The aetiology of phobias: a non-associative account. Clin Psychol Rev 1:23–48
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
Obel C, Hedegaard M, Henriksen TB, Secher NJ, Olsen J, Levine S (2005) Stress and salivary cortisol during pregnancy. Psychoneuroendocrinology 30:647–656
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
Öst L (1992) Blood and Injection Phobia. Background and cognitive, physiological and behavioral variables. J Abnorm Psychol 101:68–74
Öst L, Hellström K, Kåver A (1992) One versus five sessions of exposure in the treatment of injection phobia. Behavior Theraphy 23:263–282
Page AC (1996) Blood-injury-injection fears in medical practice. Med J Aust 164:189
Patel MX, Baker D, Nosarti C (2005) Injection phobia: a systematic review of psychological treatments. Behav Cogn Psychother 33:343–349
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
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
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
Weinstock M (2005) The potential influence of maternal stress hormones on development and mental health of the offspring. Brain Behav Immun 19:296–308
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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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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