Clinical trial NCT00602732: Interpersonal Treatment Program to Prevent Depression and Post-Traumatic Stress Disorder in Low-Income Pregnant Women With Partner Abuse
Official title: Intervention for Low-income Pregnant Women With Partner Abuse
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Depression, Postpartum
Depression
Keywords: Partner Abuse
Preventive Intervention
Postpartum Depression
Postpartum PTSD
Lead sponsor: Butler Hospital
Sponsor class: OTHER
Collaborators: name: National Institute of Mental Health (NIMH)
First posted: 2008-01-28
Enrollment: 60
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: This study will evaluate the effectiveness of an interpersonally oriented treatment program called Reach Out for a Safe Environment in preventing depression and post-traumatic stress disorder in low-income pregnant women who have experienced recent partner abuse.

Detailed description: Each year, approximately 324,000 pregnant women experience partner abuse (PA). With the emotional highs and lows that accompany new motherhood, pregnancy is often a challenging process for many women. Experiencing PA, while already going through a vulnerable time during pregnancy, may have harmful effects on the well-being of the woman and her infant. Women affected by PA are at an increased risk for certain physical and psychological problems, including depression and post-traumatic stress disorder (PTSD). Furthermore, the emotional distress from PA may impair a woman's ability to seek out the necessary support to ensure the safety of herself and her children. There have been few research efforts to develop an effective treatment to reduce the psychological impact of PA on pregnant women and even fewer efforts that target low-income women, who make up a large portion of affected women. The Reach Out for a Safe Environment (ROSE) program is an interpersonally oriented treatment developed to address factors that may contribute to postpartum mental health difficulties associated with PA. This study will evaluate the effectiveness of the ROSE program in preventing depression and PTSD in low-income pregnant women who have experienced recent PA.

Participation in this single-blind study will last approximately 29 weeks. All potential participants will answer an initial questionnaire concerning their history of physical, sexual, or emotional abuse in the past year. Selected participants will then undergo an interview about symptoms of depression, reactions to trauma, emotional difficulties, and alcohol and drug use. Participants invited to continue in the study will then be randomly assigned to the ROSE program or enhanced care as usual (ECU). Participants assigned to the ROSE program will attend four weekly 90-minute group sessions prior to delivery and one individual 50-minute booster session within 4 weeks of delivery. During these sessions, participants will learn ways to manage stress and negative feelings and how to access helpful resources. Participants will also complete two questionnaires about emotional difficulties per week for the duration of the program. Participants assigned to ECU will receive the usual medical care provided for pregnant women and will receive educational material on depression.

All participants will complete questionnaires and interviews about their emotional difficulties, relationships with others, and use of services for these difficulties prior to treatment assignment, 4 weeks after treatment assignment, 4 weeks after delivery, and 3 months after delivery. Participants in the ROSE program will additionally complete a questionnaire about their perceptions of the program after the fourth treatment session and after the booster session.

Eligibility criteria: Inclusion Criteria:

* Able to speak and read English sufficiently to complete the study procedures
* Willing and able to receive public assistance
* Identified as having experienced physical assault based on responses to CTS2 within 1 year prior to study entry
* 35 weeks or less gestation

Exclusion Criteria:

* Meets current criteria for major depressive disorder or post-traumatic stress disorder

Primary outcomes:
measure: Longitudinal Interval Follow-up Examination (LIFE)
timeFrame: Measured at Year 1
Secondary outcomes:
measure: Revised Conflict Tactic Scale (CTS2)
timeFrame: Measured at Year 1
measure: Edinburgh Postnatal Depression Scale
timeFrame: Measured at Year 1
measure: The Davidson Trauma Scale
timeFrame: Measured at Year 1
measure: The Arizona Social Support Interview Schedule
timeFrame: Measured at Year 1
measure: Parenting Stress Index
timeFrame: Measured at Year 1
Other outcomes:
Locations:
city: Providence
country: United States
facility: Memorial Hospital
state: Rhode Island
Study officials:
affiliation: Butler Hospital
name: Caron Zlotnick, PhD
role: PRINCIPAL_INVESTIGATOR
References: