PURPOSE: To examine the effects of a guided imagery (GI) intervention on perceived psychological stress in pregnant adolescents over time

BACKGROUND: Chronic maternal stress can have a negative impact on birth outcomes including the physical, cognitive, and psychological development of a child with effects lasting throughout their lifespan (Rice et al., 2010). Pregnant teens are likely to experience high levels of stress due to economic strain, family stress, risk of medical complications, decreased peer social supports, and interrupted development (Beers & Hollo, 2009). Support services for pregnant teens are limited, and there are few interventions addressing pregnant teens’ unique stressors. Guided imagery is a low-cost, easily accessible relaxation technique that effectively reduces stress in pregnant adult women (Jallo, Bourguignon, Taylor, & Utz, 2008) but has not been studied in pregnant adolescents.

DESIGN: A quasi-experimental one-way repeated-measures design was used.

PARTICIPANTS: Thirty-five pregnant female participants ages 14–19 yr (mean [M] = 16.57, standard error = 1.17) were recruited in waves from a local alternative education program during two consecutive academic school years. All pregnant students, ages 13–21 yr, enrolled in the alternative education program for parenting teens were eligible to participate. Participants who delivered their babies prior to completing four sessions of guided imagery intervention were excluded from the study.

METHOD: Participants listened to a 12-min, 51-s pregnancy-specific guided imagery recording on four separate occasions in the alternative education classroom during their pregnancies. The Psychological Stress Measure–9 (PSM–9) was given as a pretest and posttest before and after each guided imagery listening session.

ANALYSIS: A 2 (pre–post) × 4 (session number) within-subjects repeated-measures analysis of covariance was used with duration of the intervention (M = 23.89, range = 7–44 days) as a covariate and post hoc pairwise comparisons with least significant difference. The independent variable was time, and the dependent variable was perceived psychological stress.

RESULTS: When pre- and post-PSM–9 scores were compared for each session, participants demonstrated a significant reduction in stress. Participants also demonstrated a significant decrease in baseline stress levels across the four listening sessions. The greatest reductions in stress within and between sessions occurred early in the intervention with effects diminishing over time.

DISCUSSION: Pregnant teens experienced initial short- and long-term stress reductions during a guided imagery intervention, supporting using guided imagery for reducing stress in pregnant adolescents.

IMPACT STATEMENT: A guided imagery intervention to reduce stress may be a useful component of a larger program promoting wellness in pregnant adolescents in which occupational therapists can positively support healthy development of a mother–child dyad with both generations in the pediatric stages of development.

Beers, L. A. S., & Hollo, R. E. (2009). Approaching the adolescent-headed family: A review of teen parenting. Current Problems in Pediatric and Adolescent Health Care, 39, 216–233. http://dx.doi.org/10.1016/j.cppeds.2009.09.001

Jallo, N., Bourguignon, C., Taylor, A. G. E., & Utz, S. W. (2008). Stress management during pregnancy: Designing and evaluating a mind-body intervention. Family & Community Health Complementary Practice and Products, 31, 190–203. http://dx.doi.org/10.1097/01.FCH.0000324476.48083.41

Rice, F., Harold, G. T., Boivin, J., van den Bree, M., Hay, D. F., & Thapar, A. (2010). The links between prenatal stress and offspring development and psychopathology: Disentangling environmental and inherited influences. Psychological Medicine, 40, 335–345. http://dx.doi.org/10.1017/S003329170900591