O8: A Prevention Program for Postpartum OCD

There has been a recent rise in research focused on maternal psychological conditions during the perinatal period. Although the majority of investigations have examined postpartum depression, there is a growing appreciation for the deleterious consequences of maternal anxiety in the perinatal period for both the mother and child. Obsessive compulsive disorder (OCD), in particular, has emerged as a desirable target for intervention. This presentation will discuss the development of an indicated prevention program for postpartum obsessive compulsive symptoms (OCS), along with findings from the initial randomized controlled trial. Participants included women in their 2nd or 3rd trimester of their first pregnancy, who were pre-screened to determine psychological vulnerability to OCD. The treatment group (n=38) received a CBT prevention program for OCS that was incorporated into six weekly prenatal education (PE) classes. The control group (n=33) received the same PE classes along with general psychoeducation on anxiety disorders. Results revealed that at 1, 3, and 6 months postpartum, the prevention program was associated with significantly lower levels of obsessions and compulsions than was the control condition. Group differences remained significant even after controlling for baseline OCS and depression symptoms. Those in the prevention condition also reported decreasing levels of cognitive distortions, in contrast to the control condition. Significant predictors of 1-month postpartum OCS were baseline levels of OCS, thought-action fusion, and distress tolerance. Significant moderators included baseline OCS, obsessive beliefs, distress tolerance, and relationship adjustment. The interaction between these variables and condition was such that the prevention program was particularly effective for individuals who had poorer functioning at baseline. Results will be discussed with respect to implications for future intervention research on postpartum OCD.