The role of emotion dysregulation in cognitive behavioural group therapy for perinatal anxiety: Results from a randomized controlled trial and routine clinical care

Background: Emotion dysregulation (ED) has been implicated in anxiety disorders and may play an important role in Cognitive Behavioural Therapy (CBT) treatment for perinatal anxiety outcomes although there is a dearth of research in this area. The current study investigated the role of ED in perinatal anxiety treatment outcome to determine whether it impacts CBT treatment outcomes and whether CBT reduces ED. Methods: Secondary analyses were run on a sample of N = 75 women participating in a CBT for perinatal anxiety randomized controlled trial (RCT), and N = 47 women who received the treatment as part of routine clinical care. Participants completed measures of anxiety, depression and ED at baseline, post-CBT/post-waitlist and 3month follow-up (CBT-RCT group only). MANOVAs were conducted to determine if level of ED moderates treatment outcomes and whether CBT reduces ED. Reliable and clinically meaningful change was calculated. Results: Baseline level of ED did not moderate treatment outcomes. There were significant changes in some ED subscales over time in the CBT group compared to waitlist. Changes were reliable and clinically meaningful in 28.6% (RCT) and 16% (routine clinical care) of participants. Participants with high ED at baseline remained in the high range at post-treatment. Limitations: Limitations include low sample size; homogeneity of sample, use of measures not validated in perinatal populations. Conclusions: These findings suggest that ED during the perinatal period may be a stand-alone factor that will need to be separately addressed in psychological treatment.