Bonacquisti Alexa, Cohen Matthew J, Schiller Crystal Edler
Department of Psychology, Drexel University, 3141 Chestnut Street, Stratton Hall, Suite 119, Philadelphia, PA, 19104, USA.
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, 235 E. Cameron Avenue, Chapel Hill, NC, 27599-3270, USA.
Arch Womens Ment Health. 2017 Oct;20(5):645-654. doi: 10.1007/s00737-017-0735-8. Epub 2017 Jun 10.
Perinatal mood and anxiety disorders are a leading cause of morbidity and mortality for childbearing women. Current treatments, such as cognitive behavioral therapy and interpersonal therapy, have demonstrated modest success in addressing perinatal psychiatric symptoms; however, additional treatment options are needed to address the limitations of current approaches, particularly for women experiencing moderate to severe perinatal mental illness during pregnancy or postpartum. We discuss the use of acceptance and commitment therapy (ACT) as a promising treatment approach that may be uniquely suited for perinatal women due to its emphasis of values, mindfulness, and acceptance; these psychological constructs notably address the significant psychiatric and behavioral health condition comorbidity, somatic symptoms, and stigma associated with perinatal mood and anxiety disorders. In addition, we describe the development of a four-session ACT-based group intervention at the Perinatal Psychiatry Inpatient Unit at the University of North Carolina at Chapel Hill. Sessions focus on core ACT processes of acceptance, cognitive defusion, present-moment awareness, value identification, and goal setting, and we describe how each of these processes is relevant to the perinatal population. Implications for future clinical applications and research investigations are discussed.
围产期情绪和焦虑障碍是育龄妇女发病和死亡的主要原因。目前的治疗方法，如认知行为疗法和人际疗法，在解决围产期精神症状方面已取得一定成效；然而，需要更多的治疗选择来克服当前方法的局限性，特别是对于在孕期或产后经历中度至重度围产期精神疾病的妇女。我们讨论了接纳与承诺疗法（ACT）作为一种有前景的治疗方法，由于其对价值观、正念和接纳的强调，可能特别适合围产期妇女；这些心理结构尤其适用于解决与围产期情绪和焦虑障碍相关的严重精神和行为健康状况共病、躯体症状以及耻辱感。此外，我们描述了北卡罗来纳大学教堂山分校围产期精神病住院单元基于ACT的四节小组干预的开展情况。课程聚焦于ACT的核心过程，即接纳、认知解离、当下觉察、价值观识别和目标设定，我们还阐述了这些过程与围产期人群的相关性。同时讨论了对未来临床应用和研究调查的启示。
