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Help-seeking and treatment delivery preferences for women experiencing perinatal anxiety symptoms

Published online by Cambridge University Press:  03 April 2023

Peta N. Maguire Open the ORCID record for Peta N. Maguire [Opens in a new window] ,
Navjot Bhullar Open the ORCID record for Navjot Bhullar [Opens in a new window] ,
Suzanne M. Cosh Open the ORCID record for Suzanne M. Cosh [Opens in a new window]  and
Bethany M. Wootton Open the ORCID record for Bethany M. Wootton [Opens in a new window]
Peta N. Maguire
Affiliation:
School of Psychology, University of New England, Australia
Navjot Bhullar
Affiliation:
School of Psychology, University of New England, Australia Discipline of Psychology, Edith Cowan University, Australia
Suzanne M. Cosh
Affiliation:
School of Psychology, University of New England, Australia
Bethany M. Wootton*
Affiliation:
Discipline of Clinical Psychology, University of Technology Sydney, Australia
*
*Corresponding author. Email: bethany.wootton@uts.edu.au
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Abstract

Background:

Anxiety is common during the perinatal period and despite effective treatments being available, many women with perinatal anxiety disorders experience barriers when accessing treatment.

Aims:

The aims of the current study were to explore women’s perceived barriers to treatment uptake; cognitive behavioural therapy (CBT) treatment delivery preferences; and the utility of the Health Belief Model (HBM) in predicting intention to seek psychological help for women with perinatal anxiety symptoms.

Method:

This study employed a cross-sectional design consisting of women with self-reported anxiety in the perinatal period. A total of 216 women (M age=28.53 years; SD=4.97) participated in the study by completing a battery of online self-report measures.

Results:

The results indicated that the most salient barriers to accessing care were: (1) the cost of treatment, (2) wanting to solve the problem on their own, and (3) thinking the problem would go away without treatment. Group-delivered CBT was the least acceptable treatment method, while face-to-face individual CBT was the most acceptable treatment method. The HBM variables predicted approximately 35% of the variance in help-seeking intention.

Discussion:

This study has important implications for the delivery of psychological care in the perinatal period and may be used to improve treatment uptake.

Keywords

anxietyHealth Belief Modelperinatalpregnancytreatment
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 51 , Issue 4 , July 2023 , pp. 271 - 285
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

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References

Austin, M., Highet, N., & Expert Working Group (2017). Mental health care in the perinatal period: Australian clinical practice guideline. C. o. P. Excellence.Google Scholar
Campbell-Sills, L., Norman, S. B., Craske, M. G., Sullivan, G., Lang, A. J., Chavira, D. A., Bystritsky, A., Sherbourne, C., Roy-Byrne, P., & Stein, M. B. (2008). Validation of a brief measure of anxiety-related severity and impairment: the Overall Anxiety Severity and Impairment Scale (OASIS). Journal of Affective Disorders, 112, 92–101. https://doi.org/10.1016/j.jad.2008.03.014 CrossRefGoogle ScholarPubMed
Chou, Y.-J., & Shih, C.-M. (2018). Using the health belief model to predict those seeking treatment for hypoactive sexual desire disorder among premenopausal women. Taiwanese Journal of Obstetrics & Gynecology, 57, 791–795. https://doi.org/10.1016/j.tjog.2018.10.003 CrossRefGoogle ScholarPubMed
Clement, S., Brohan, E., Jeffery, D., Henderson, C., Hatch, S. L., & Thornicroft, G. (2012). Development and psychometric properties the Barriers to Access to Care Evaluation scale (BACE) related to people with mental ill health. BMC Psychiatry, 12, 36. https://doi.org/10.1186/1471-244X-12-36 CrossRefGoogle ScholarPubMed
Cohen, J. (1992). Statistical power analysis. Current Directions in Psychological Science, 1, 98–101. https://doi.org/10.1111/1467-8721.ep10768783 CrossRefGoogle Scholar
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786. https://doi.org/10.1192/bjp.150.6.782 CrossRefGoogle ScholarPubMed
Farajzadegan, Z., Fathollahi-Dehkordi, F., Hematti, S., Sirous, R., Tavakoli, N., & Rouzbahani, R. (2016). The transtheoretical model, health belief model, and breast cancer screening among Iranian women with a family history of breast cancer. Journal of Research in Medical Sciences, 21, 122. https://doi.org/10.4103/1735-1995.193513 Google ScholarPubMed
Field, A. (2018). Discovering Statistics Using IBM SPSS Statistics. 5th Edition, SAGE Publications Ltd., London.Google Scholar
Forsell, E., Bendix, M., Holländare, F., Szymanska von Schultz, B., Nasiell, J., Blomdahl-Wetterholm, M., Eriksson, C., Kvarned, S., Lindau van der Linden, J., Söderberg, E., Jokinen, J., Wide, K., & Kaldo, V. (2017). Internet delivered cognitive behavior therapy for antenatal depression: a randomised controlled trial. Journal of Affective Disorders, 221, 56–64. https://doi.org/10.1016/j.jad.2017.06.013 CrossRefGoogle ScholarPubMed
Franco-Antonio, C., Santano-Mogena, E., Sánchez-García, P., Chimento-Díaz, S., & Cordovilla-Guardia, S. (2021). Effect of a brief motivational intervention in the immediate postpartum period on breastfeeding self-efficacy: randomized controlled trial. Research in Nursing Health, 44, 295–307. https://doi.org/10.1002/nur.22115 CrossRefGoogle ScholarPubMed
Gaspersz, R., Nawijn, L., Lamers, F., & Penninx, BWJH. (2018) Patients with anxious depression: overview of prevalence, pathophysiology and impact on course and treatment outcome. Current Opinion in Psychiatry, 31, 17–25. http://doi.org/10.1097/YCO.0000000000000376 CrossRefGoogle ScholarPubMed
Goodman, J. (2009). Women’s attitudes, preferences, and perceived barriers to treatment for perinatal depression. Birth Issues in Perinatal Care, 39, 60–69. https://doi.org/10.1111/j.1523-536X.2008.00296.x CrossRefGoogle Scholar
Goodman, J., Watson, G., & Stubbs, B. (2016). Anxiety disorders in postpartum women: a systematic review and meta-analysis. Journal of Affective Disorders, 203, 292–331. https://doi.org/10.1016/j.jad.2016.05.033 CrossRefGoogle ScholarPubMed
Hathorn, S., Lochner, C., Stein, D., & Bantjes, J. (2021). Help-seeking intention in obsessive-compulsive disorder: predictors and barriers in South Africa. Frontiers in Psychiatry, 12, 733773. https://doi.org/10.3389/fpsyt.2021.733773 CrossRefGoogle ScholarPubMed
Heinig, I., Wittchen, H.-U., & Knappe, S. (2021). Help-seeking behavior and treatment barriers in anxiety disorders: results from a representative German Community Survey. Community Mental Health Journal, 57, 1505–1517. https://doi.org/10.1007/s10597-020-00767-5 CrossRefGoogle ScholarPubMed
Henshaw, E., & Freedman-Doan, C. (2009). Conceptualizing mental health care utilization using the Health Belief Model. Clinical Psychology: Science & Practice, 16, 420–439. doi: 420.1111/j.1468-2850.2009.01181.x.Google Scholar
IBM Corporation (2020). IBM SPSS Statistics for Windows, Version 27.0.Google Scholar
Kheirabadi, G., Maracy, M., Akbaripour, S., & Masaeli, N. (2012). Psychometric properties and diagnostic accuracy of the Edinburgh postnatal depression scale in a sample of Iranian women. Iranian Journal of Medical Science, 37, 32–38. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470287/ Google Scholar
Kladnitski, N., Smith, J., Uppal, S., James, M. A., Allen, A. R., Andrews, G., & Newby, J. M. (2020). Transdiagnostic internet-delivered CBT and mindfulness-based treatment for depression and anxiety: a randomised controlled trial. Internet Interventions, 20, 100310. https://doi.org/10.1016/j.invent.2020.100310 CrossRefGoogle ScholarPubMed
Komariah, M., Amirah, S., Faisal, E. G., Prayogo, S. A., Maulana, S., Platini, H., Suryani, S., Yosep, I., & Arifin, H. (2022). Efficacy of internet-based cognitive behavioral therapy for depression and anxiety among global population during the covid-19 pandemic: a systematic review and meta-analysis of a randomized controlled trial study. Healthcare (Basel), 10, 1224. http://doi.org/10.3390/healthcare10071224 CrossRefGoogle ScholarPubMed
Langley, E., Clark, G., Murray, C., & Wootton, B. (2020). The utility of the Health Belief Model variables in predicting help-seeking for depressive symptoms. Australian Psychologist. https://doi.org/10.1080/00050067.2021.1893598 Google Scholar
Langley, E., Wootton, B., & Grieve, R. (2018). The utility of the Health Belief Model variables in predicting help-seeking intention for anxiety disorders. Australian Psychologist, 53, 291–301. https://doi.org/10.1111/ap.12334 CrossRefGoogle Scholar
Loftus, J., Allen, E. M., Call, K. T., & Everson-Rose, S. A. (2018). Rural–urban differences in access to preventive health care among publicly insured Minnesotans. Journal of Rural Health, 34 (suppl 1), S48–55. https://doi.org/10.1111/jrh.12235 CrossRefGoogle ScholarPubMed
Logsdon, M., Usui, W., & Nering, M. (2009). Validation of Edinburgh postnatal depression scale for adolescent mothers. Archives of Womens Mental Health, 2, 433–440. https://doi.org/10.1007/s00737-009-0096-z CrossRefGoogle Scholar
Maguire, P., Clark, G., Cosh, S., & Wootton, B. (2022). Exploring experiences, barriers and treatment preferences for self-reported perinatal anxiety in Australian women: a qualitative study [under review].Google Scholar
Maguire, P., Clark, G., & Wootton, B. (2018). The efficacy of cognitive behavior therapy for the treatment of perinatal anxiety symptoms: a preliminary meta-analysis. Journal of Anxiety Disorders, 60, 26–34. https://doi.org/10.1016/j.janxdis.2018.10.002 CrossRefGoogle ScholarPubMed
Marques, L., LeBlanc, N. J., Weingarden, H. M., Timpano, K. R., Jenike, M., & Wilhelm, S. (2010). Barriers to treatment and service utilization in an internet sample of individuals with obsessive-compulsive symptoms. Depression and Anxiety, 4, 470–475. https://doi.org/10.1002/da.20694 CrossRefGoogle Scholar
Mascioli, B. A., & Davis, R. (2019). Health-protective eating style among students at a Canadian University. Canadian Journal of Behavioural Science, 51, 269–277. https://doi.org/10.1037/cbs0000145 CrossRefGoogle Scholar
McCausland, J., Paparo, J., & Wootton, B. (2021, Sep). Treatment barriers, preferences and histories of individuals with symptoms of body dysmorphic disorder. Behavioural and Cognitive Psychotherapy, 49, 582–595. https://doi.org/10.1017/s1352465820000843 CrossRefGoogle ScholarPubMed
Milgrom, J., Gemmill, A. W., Ericksen, J., Burrows, G., Buist, A., & Reece, J. (2015). Treatment of postnatal depression with cognitive behavioural therapy, sertraline and combination therapy: a randomised controlled trial. Australian & New Zealand Journal of Psychiatry, 49, 236–245. http://doi.org/10.1177/0004867414565474 CrossRefGoogle ScholarPubMed
Misri, S., Reebye, P., Corral, M., & Milis, L. (2004). The use of paroxetine and cognitive-behavioral therapy in postpartum depression and anxiety: a randomized controlled trial. Journal of Clinical Psychiatry, 65, 1236–1241. http://doi.org/10.4088/jcp.v65n0913 CrossRefGoogle ScholarPubMed
Moore, C. D., Schofield, C., van Rooyen, D. R., & Andersson, L. M. (2015). Development and preliminary validation of a scale to measure self-efficacy in seeking mental health care (SE-SMHC). SpringerPlus, 4, 339. https://doi.org/10.1186/s40064-015-1109-1 CrossRefGoogle ScholarPubMed
Norman, S. B., Hami Cissell, S., Means-Christensen, A. J., & Stein, M. B. (2006). Development and validation of an Overall Anxiety Severity And Impairment Scale (OASIS). Depression and Anxiety, 4, 245–249. https://doi.org/10.1002/da.20182 CrossRefGoogle Scholar
O’Connor, P., Martin, B., Weeks, C., & Ong, L. (2014). Factors that influence young people’s mental health help-seeking behaviour: a study based on the Health Belief Model. Journal of Advanced Nursing, 70, 2577–2587. https://doi.org/10.1111/jan.12423 CrossRefGoogle ScholarPubMed
Prins, M., Meadows, G., Bobevski, I., Graham, A., Verhaak, P., van der Meer, K., Penninx, B., & Bensing, J. (2011). Perceived need for mental health care and barriers to care in the Netherlands and Australia. Social Psychiatry and Psychiatric Epidemiology, 46, 1033–1044. https://doi.org/10.1007/s00127-010-0266-3 CrossRefGoogle ScholarPubMed
Puertas-Gonzalez, J. A., Mariño-Narvaez, C., Romero-Gonzalez, B., & Peralta-Ramirez, M. I. (2021). Stress and psychopathology reduction in pregnant women through online cognitive behavioural therapy during COVID-19: a feasibility study. Behavioural Science, 11, 100. http://doi.org/10.3390/bs11070100 CrossRefGoogle ScholarPubMed
Reck, C., Van Den Bergh, B., Tietz, A., Müller, M., Ropeter, A., Zipser, B., & Pauen, S. (2018). Maternal avoidance, anxiety cognitions and interactive behaviour predicts infant development at 12 months in the context of anxiety disorders in the postpartum period. Infant Behaviour and Development, 50, 116–131. http://doi.org/10.1016/j.infbeh CrossRefGoogle ScholarPubMed
Rees, C., & Maclaine, E. (2015). A systematic review of videoconference-delivered psychological treatment for anxiety disorders. Australian Psychologist, 50, 259–264. https://doi.org/10.1111/ap.12122 CrossRefGoogle Scholar
Rees, S., Channon, S., & Waters, C. S. (2019). The impact of maternal prenatal and postnatal anxiety on children’s emotional problems: a systematic review. European Child and Adolescent Psychiatry, 28, 257–280. https://doi.org/10.1007/s00787-018-1173-5 CrossRefGoogle ScholarPubMed
Robertson, L., Paparo, J., & Wootton, B. M. (2020). Understanding barriers to treatment and treatment delivery preferences for individuals with symptoms of hoarding disorder: a preliminary study. Journal of Obsessive-Compulsive and Related Disorders, 26, 100560. https://doi.org/10.1016/j.jocrd.2020.100560 CrossRefGoogle Scholar
Rominov, H., Pilkington, P. D., Giallo, R., & Whelan, T. A. (2016). A systematic review of interventions targeting paternal mental health in heath in the perinatal period. Infant Mental Health Journal, 37, 289–301. http://doi.org/10.1002/imhj.21560 CrossRefGoogle Scholar
Rosenstock, I. M. (1966). Why people use health services. The Milbank Memorial Fund Quarterly. Health and Society, 44, 94–127. https://doi.org/10.2307/3348967 CrossRefGoogle ScholarPubMed
Saleeby, J. (2000). Health beliefs about mental illness: an instrument development study. American Journal of Health Behavior, 24, 83–95. https://doi.org/10.5993/AJHB.24.2.1 CrossRefGoogle Scholar
Scherr, C. L., Jensen, J. D., & Christy, K. (2017). Dispositional pandemic worry and the health belief model: promoting vaccination during pandemic events. Journal of Public Health, 39, E242–250. https://doi.org/10.1093/pubmed/fdw101 Google ScholarPubMed
Smith, M. S., Lawrence, V., Sadler, E., & Easter, A. (2019). Barriers to accessing mental health services for women with perinatal mental illness: systematic review and meta-synthesis of qualitative studies in the UK. BMJ Open, 9, e024803. https://doi.org/10.1136/bmjopen-2018-024803 CrossRefGoogle Scholar
Smith, S., Paparo, J., & Wootton, B. (2021). Understanding psychological treatment barriers, preferences and histories of individuals with clinically significant depressive symptoms in Australia: a preliminary study. Clinical Psychologist. https://doi.org/10.1080/13284207.2021.1892453 CrossRefGoogle Scholar
Stålner, O., Nordin, S., & Madison, G. (2022). Six-Year prognosis of anxiety and depression caseness and their comorbidity in a prospective population-based adult sample. BMC Public Health, 22, 1554. http://doi.org/10.1186/s12889-022-13966-4 CrossRefGoogle Scholar
Wootton, B. M., Titov, N., Dear, B. F., Spence, J., & Kemp, A. (2011). The acceptability of Internet-Based treatment and characteristics of an adult sample with obsessive compulsive disorder: an Internet survey. PLoS One, 6, e20548. https//doi.org/10.1371/journal.pone.0020548 CrossRefGoogle ScholarPubMed
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