A Pilot Clinical Trial of SunnysideFlex to Treat Posttraumatic Stress Disorder Symptoms During Pregnancy

The perinatal period is associated with a heightened risk of psychopathologies, including affective distress, which in turn is associated with both mother and infant adverse health outcomes. Although extensive literature exists on perinatal depression and anxiety, other perinatal mental health challenges that often co-occur with depression, such as posttraumatic stress disorder (PTSD), have received less attention. Approximately 4-8% of pregnant women meet criteria for PTSD during pregnancy, while it can also negatively impact forming of a secure relationship between mother and infant, from pregnancy through postpartum. Despite scientifically supported interventions for treating PTSD in the general population, treating PTSD during pregnancy has remained an understudied area and there is limited clarity of treatment guidelines for prenatal PTSD. Available research on perinatal interventions for PTSD more broadly suggests that addressing trauma during pregnancy is safe, feasible, and acceptable. In this pilot study, we assessed the feasibility, acceptability, and preliminary effectiveness of SunnysideFlex, a web-based cognitive behavioral therapy (CBT) intervention tailored for targeting PTSD symptoms during pregnancy. This study had three aims. First, we analyzed individual-level changes in PTSD symptoms pre- to post-intervention. Second, we assessed the individual-level changes in self-reported measures of mother-infant bonding and attachment pre- to post-intervention. Third, we conduced individual-level analyses focusing on intervention adherence, engagement, and acceptability (i.e., overall usefulness, ease of use, ease of learning, and satisfaction), and their potential association with the individual’s changes in PTSD symptoms, as well as mother and infant bonding and attachment, utilizing a descriptive approach. The primary clinical outcome of this study was a reduction in PTSD symptoms, with 85% of participants showing clinically meaningful reductions in PTSD symptoms from pre- to post-intervention. The results related to mother-infant bonding and attachment from pre- to post-intervention timepoints were more nuanced, such that only 5.5% of participants demonstrated a clinically significant improvement in bonding. Similarly, 4% showed a clinically significant increase in attachment. Overall, the individual-level analysis of engagement and clinical outcomes suggested an association between higher program engagement and improvements in key study outcomes, particularly PTSD symptoms. However, the relationship between tool usage and level of improvement in PTSD symptoms was not consistently clear. On the other hand, intervention adherence was high as all participants completed the 6-week SunnysideFlex program and engaged with an average of 10.75 out of 13 lessons. Overall, this pilot study provided preliminary support for the efficacy, feasibility, and acceptability of SunnysideFlex program as an evidence-based online intervention for improving PTSD symptoms in pregnant women.

Author dc:creator

• Shiva Edalatian Zakeri (11713067)

• Pregnant women with lifetime interpersonal trauma exposure

Statement dc:rights

• In Copyright

DOI dc:identifier

https://doi.org/10.25417/uic.31451050.v1

OAI identifier oai:identifier

oai:figshare.com:article/31451050