CBT for Postpartum Depression and Infant Emotion Regulation

The Impact of Treating Postpartum Depression on Infant Emotion Regulation

The primary objective of this study is to determine if online group cognitive behavioral therapy (CBT) for maternal postpartum depression (PPD) added to treatment as usual (TAU) leads to greater improvements in infant emotion regulation (ER) than maternal receipt of TAU alone immediately post-treatment, 6 and 30 months later. This study will also aim to determine what mechanisms PPD treatment leads to changes in infant ER.

A prospective, single-blind, parallel randomized controlled trial (1:1 ratio) that includes an experimental (receipt of a 9-week group CBT intervention delivered online plus TAU) and control group (TAU alone) to address our objectives. Participants will have an EPDS score of 10 or more and an infant 3-12 months of age and be recruited from the community. The experimental group will receive a validated 9-week online group cognitive behavioral therapy (CBT) intervention on Zoom plus TAU. The control group will receive TAU alone. In both groups, TAU will consist of regular care from their family doctor, midwife, OB/GYN an/or any other types of care they may be accessing. The trial intervention consists of nine, 2-hour sessions occurring once per week. The first half of each session is devoted to core CBT content, including cognitive restructuring. The second half is devoted to group discussions co-led by participants on topics relevant to mothers with PPD (e.g., sleep, supports, role transitions). Groups will be delivered by two trained psychologists, social workers, nurses, and/or psychiatrists. Primary objective: Determine if online group cognitive behavioural therapy (CBT) for maternal PPD added to treatment as usual (TAU) lead to greater improvements in infant ER than maternal receipt of TAU alone immediately post-treatment, 6 months and 30 months later. Secondary objective: Determine the putative mechanisms through which PPD treatment leads to changes in infant ER.

Inclusion Criteria:

• women 18 years of age or older
• understand and speak English (so that they can participate in the CBT group and complete study measures)
• live in Ontario (the primary WHCC catchment area)
• have an EPDS score of 10 or more
• meets diagnostic criteria for comorbid psychiatric conditions.
• Infants must be between 4-12 months old at enrollment.

Exclusion Criteria:

• bipolar disorder
• a current psychotic disorder
• substance or alcohol use disorder
• antisocial or borderline personality disorder.