UCLA

This dissertation is a three-paper investigation of psychological interventions for pregnant ethnic and racial minority women with anxiety and depression. Study 1 reviews the treatment outcome literature for pregnant Black women and Latinas with depressive and anxious symptoms, including their efficacy, mode of delivery (i.e., provider of intervention, setting), and the presence of cultural adaptations. Results revealed that treatment outcome studies for Latinas and Black women are lacking, and often do not result in favorable outcomes for depression or anxiety. Though CBT and IPT are the intervention modalities most often tested to treat depression, they require additional trials to be considered efficacious. No intervention trials have achieved favorable outcomes with regard to anxiety reduction in Latinas and Black women.

Study 2 used data from a randomized controlled trial of a cognitive behavioral stress management intervention delivered to Black women and Latinas to test its efficacy for prenatal anxiety (i.e., state and pregnancy specific). We also tested whether change targets of the intervention from pre- to post-treatment might mediate the relationship between intervention group and anxiety change at follow up timepoints. Findings revealed that while the intervention was not efficacious for reducing prenatal anxiety, women who completed the intervention showed significantly fewer state anxiety symptoms at post-treatment than did women in the control condition—effects that were not lasting. Changes in the potential mediators tested did not explain the relationship between intervention group and subsequent changes in anxiety.

Study 3 investigated pregnant Latinas’ acceptability of exposure therapy to treat prenatal anxiety using a deductive qualitative design. Using an existing theoretical framework of treatment acceptability, we interviewed women about seven domains of treatment acceptability. Results of a qualitative content analysis show that culture, family, and pregnancy status are factors that can serve as relevant exposure acceptability enhancers or challenges and provide insights for tailoring psychoeducation about exposure therapy prenatally. Collectively, these studies further the treatment outcome literature for pregnant Latinas and Black women, whose outcomes in available psychological interventions have been presumed to be equivalent to those of white women.