title: Prevention of traumatic stress in mothers with preterm infants: a randomized controlled trial.
abstract: OBJECTIVE
  The current study evaluates a treatment intervention developed with the goal of reducing symptoms of posttraumatic stress, depression, and anxiety in parents of premature infants.
  
  
  METHODS
  A total of 105 mothers of preterm infants (25-34 weeks' gestational age; >600 g) were randomized to receive a 6-session intervention developed to target parental trauma as well as facilitate infant redefinition (n = 62) or to an active comparison group (n = 43). Mothers in the intervention group received a combination of trauma-focused treatments, including psychoeducation, cognitive restructuring, progressive muscle relaxation, and development of their trauma narrative. The intervention also incorporated material targeting infant redefinition, defined as the process of changing the mother's negative perceptions of her infant and the parenting experience.
  
  
  RESULTS
  Mothers in the intervention group reported a greater reduction in both trauma symptoms (Cohen's d = 0.41, P = .023) and depression (Cohen's d = 0.59, P < .001) compared with the comparison group. Patients under both conditions improved significantly in terms of anxiety, with no differences between groups. Results of the moderator analysis showed that mothers with higher ratings of baseline NICU stress benefited more from the intervention compared with mothers who had lower ratings (P = .036).
  
  
  CONCLUSIONS
  This short, highly manualized intervention for mothers of preterm infants statistically significantly reduced symptoms of trauma and depression. The intervention is feasible, can be delivered with fidelity, and has high ratings of maternal satisfaction. Given that improvements in mothers' distress may lead to improved infant outcomes, this intervention has the potential for a high public health impact.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Palo Alto, CA 94305-5719. rjshaw@stanford.edu.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Shaw
authors.forename: Nick
authors.initials: N
authors.lastname: St John
authors.forename: Emily A
authors.initials: EA
authors.lastname: Lilo
authors.forename: Booil
authors.initials: B
authors.lastname: Jo
authors.forename: William
authors.initials: W
authors.lastname: Benitz
authors.forename: David K
authors.initials: DK
authors.lastname: Stevenson
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Horwitz
mesh_terms: D000328:Adult; D003863:Depression / Q000517:prevention & control / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D008429:Maternal Welfare / Q000523:psychology*; D009035:Mothers / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D011247:Pregnancy; D013315:Stress, Psychological / Q000517:prevention & control* / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: intervention; neonatal intensive care; posttraumatic stress disorder; premature infants