Cognitive behavioral therapy and pharmacotherapy for anxiety: treatment preferences and credibility among pregnant and non-pregnant women

Behav Res Ther. 2014 Jan:52:53-60. doi: 10.1016/j.brat.2013.11.003. Epub 2013 Nov 22.

Abstract

Background: Relatively little is known about women's anxiety-related treatment preferences and no studies have examined potential differences between pregnant versus non-pregnant women. Treatment credibility and willingness are particularly important to understand regarding exposure-based cognitive behavioral therapy (CBT) and pharmacotherapy, the leading evidence-based treatments.

Methods: A large U.S. sample of pregnant (n = 377) and matched non-pregnant (n = 399) women (total N = 776) rated overall treatment preferences and treatment credibility, concerns, and willingness to have CBT and pharmacotherapy if suffering from anxiety.

Results: Women preferred anxiety-related treatment that included psychotherapy. Preference for psychotherapy alone was stronger among pregnant (74%) than non-pregnant (47%) women, p < .001. In response to treatment descriptions, both groups rated CBT more favorably than pharmacotherapy on treatment willingness, credibility, and concerns, ps < .001, with the magnitude of this preference significantly greater among pregnant than non-pregnant women, ps < .001. Pregnancy status was unrelated to CBT ratings. Treatment credibility and to a lesser extent total concerns mediated the relationship between pregnancy status and pharmacotherapy willingness.

Conclusions: Non-pregnant and especially pregnant women rated exposure-based CBT for anxiety more favorably than pharmacotherapy. Pregnancy status predicted general treatment preferences and pharmacotherapy, but not CBT, ratings.

Keywords: Anxiety; Anxiety disorders; Cognitive behavioral therapy; Pharmacotherapy; Pregnancy.

MeSH terms

  • Adult
  • Anti-Anxiety Agents / therapeutic use*
  • Anxiety Disorders / drug therapy
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Attitude to Health*
  • Cognitive Behavioral Therapy*
  • Female
  • Humans
  • Pregnancy
  • United States
  • Women / psychology*
  • Young Adult

Substances

  • Anti-Anxiety Agents