Researchers Link Anxiety Sensitivity to Postpartum Distress

Simple interventions during pregnancy could ease postpartum depression, parental distress

AUGUST 2, 2023 BY ERIN GARRETT

One in eight women who have recently given birth will experience postpartum depression symptoms, according to the Centers for Disease Control and Prevention. Researchers in the University of Mississippi‘s Department of Psychology have identified a prenatal risk factor that, when treated, could lessen postpartum and parental distress.

In a recent paper in the Journal of Midwifery and Women’s Health, the authors find a correlation between anxiety sensitivity in pregnant women and postpartum distress.

“One of our main questions was looking at whether anxiety sensitivity was a unique predictor of postpartum distress,” said Laura J. Dixon, associate professor of psychology. “Thinking about this in the context of pregnancy is interesting – given the many changes in the body.”

In a nutshell, anxiety sensitivity is fear of the physiological symptoms of anxiety, said Sara Witcraft, the paper’s lead author. This psychological vulnerability is known to contribute to a range of anxiety disorders and increase distress across other psychological and health-related conditions.

“Everyone knows what anxiety is, but anxiety sensitivity is something the general public may not be familiar with,” said Witcraft, who received a doctorate in clinical psychology from the university in 2022. “It boils down to the fear of fear, and the fear of sensations or experiences that are driven by anxiety.

“Things like if my heart starts racing out of nowhere, I might interpret that to think I am having a heart attack. People with heightened anxiety sensitivity might think sweating and blushing mean that something bad is happening. It’s also the fear of the consequences of these symptoms.”

Typical pregnancy symptoms such as numbness, shortness of breath, abdominal pain and dizziness could be catastrophized by individuals with anxiety sensitivity.

In the paper, the authors state that anxiety sensitivity may be “an important and malleable risk factor” associated with prenatal mental health. Treating prenatal anxiety sensitivity could prevent or reduce postpartum distress and prevent the onset or worsening of psychological disorders among women. This could, in turn, improve infant and child outcomes.

The study is the first to examine the role of prenatal anxiety sensitivity in postpartum maternal distress. Dixon has studied anxiety sensitivity since graduate school. During her postdoctoral fellowship in psychology at the University of Mississippi Medical Center, Dixon’s research and clinical interests merged.

“In grad school, I was interested in applying anxiety sensitivity to the prenatal and postnatal populations,” she said. “During graduate school, I treated a pregnant patient that had a panic disorder and realized there are few treatments available and many implications for research.”

The paper examines data that Dixon collected during her fellowship. She recruited participants from the Jackson community for screenings that occurred during pregnancy and postpartum. The two-hour screenings consisted of both self-reported questionnaires and interviews.

The researchers suggest that larger studies be conducted to better understand the role between anxiety sensitivity and postpartum distress. However, treating anxiety sensitivity is relatively simple through an intervention called “interoceptive exposure,” Witcraft said.

“It’s a science-y way of saying exposure to bodily sensations,” she said. “It asks people to actually bring about the physical symptoms they are afraid of – in a safe manner. We intentionally bring about these experiences in order to let them know they can tolerate them and that it’s not necessarily something bad happening.

“We might have someone spin in a chair for dizziness or breathe through a straw for breathlessness. It’s tailored to the individual, based on what their fear sensation is.”

Witcraft, a research assistant professor at the Medical University of South Carolina in Charleston, is studying this treatment among pregnant women with opioid use disorder, a chronic medical condition characterized by recurrent opioid use.

Dixon stressed the importance of research related to women’s health, pregnancy and postpartum.

“These studies can help drive health care initiatives – we’re seeing a lot of disparities in this area,” she said. “We know that women are at high risk for anxiety and depression, and during pregnancy and postpartum, there is an even higher risk of it.

“There’s not much research on evidence-based treatments that we would typically use for anxiety during pregnancy. In the past, pregnant women were excluded from clinical trials, but in the last five to 10 years, our field has circled back in terms of developing cognitive and behavioral treatments for pregnant women.”