{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T14:56:34Z","timestamp":1770821794618,"version":"3.50.1"},"reference-count":64,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T00:00:00Z","timestamp":1640908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The perinatal period is considered a window of vulnerability given the increased risk of psychiatric difficulties during this time, such as mood and anxiety disorders (ADs). Pre-pandemic rates of ADs in perinatal women were one in five but have since increased with the onset of the COVID-19 pandemic (COVID). In addition, recent research suggests that the focus of worry has shifted during the pandemic, with perinatal women reporting significantly more COVID-specific worries. The objective of this study was to augment our current evidence-based Cognitive Behavioural Group Therapy (CBGT) for perinatal anxiety protocol by targeting intolerance of uncertainty and tailoring existing strategies to address COVID-related worry and impact. Pregnant (n = 19) and postpartum (n = 49) women were recruited from regular clinic patient flow from a university-affiliated teaching hospital between September 2020 and March 2021. Improvements in generalized anxiety symptoms, worry, intolerance of uncertainty, and mood were observed at post-treatment, maintained at 3-months, and the intervention received high ratings of treatment satisfaction. This is the first study to examine an augmented CBGT for perinatal women with GAD during the pandemic and supports the inclusion of strategies that target intolerance of uncertainty as well as specific pandemic and perinatal worry content for effective outcomes.<\/jats:p>","DOI":"10.3390\/jcm11010209","type":"journal-article","created":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T20:49:38Z","timestamp":1641242978000},"page":"209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of an Augmented Cognitive Behavioural Group Therapy for Perinatal Generalized Anxiety Disorder (GAD) during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"11","author":[{"given":"Sheryl M.","family":"Green","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada"},{"name":"Women\u2019s Health Concerns Clinic, St. Joseph\u2019s Healthcare, Hamilton, ON L8N 3K7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Briar","family":"Inness","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Concerns Clinic, St. Joseph\u2019s Healthcare, Hamilton, ON L8N 3K7, Canada"},{"name":"Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON L8N 3K7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Furtado","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Concerns Clinic, St. Joseph\u2019s Healthcare, Hamilton, ON L8N 3K7, Canada"},{"name":"Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON L8N 3K7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randi E.","family":"McCabe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada"},{"name":"Anxiety Treatment and Research Clinic, St. Joseph\u2019s Healthcare, Hamilton, ON L8N 3K7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benicio N.","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada"},{"name":"Women\u2019s Health Concerns Clinic, St. Joseph\u2019s Healthcare, Hamilton, ON L8N 3K7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1002\/imhj.21443","article-title":"Transition to parenthood and mental health in first-time parents","volume":"35","author":"Parfitt","year":"2014","journal-title":"Infant Ment. Health J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Redshaw, M., and Henderson, J. (2016). Who is actually asked about their mental health in pregnancy and the postnatal period? Findings from a national survey. BMC Psychiatry, 16.","DOI":"10.1186\/s12888-016-1029-9"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"18r12527","DOI":"10.4088\/JCP.18r12527","article-title":"The Prevalence of Anxiety Disorders during Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis","volume":"80","author":"Fawcett","year":"2019","journal-title":"J. Clin. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2150132720944074","DOI":"10.1177\/2150132720944074","article-title":"A Mixed-Methods Pilot Study of Perinatal Risk and Resilience during COVID-19","volume":"11","author":"Farewell","year":"2020","journal-title":"J. Prim. Care Community Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"113348","DOI":"10.1016\/j.socscimed.2020.113348","article-title":"Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic","volume":"266","author":"Preis","year":"2020","journal-title":"Soc. Sci. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.3109\/14767058.2013.858242","article-title":"Obstetric and neonatal outcome in patients with anxiety disorders","volume":"27","author":"Pavlov","year":"2013","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.jpsychores.2013.04.010","article-title":"Maternal generalized anxiety disorder during pregnancy and fetal brain development: A comparative study on cord blood brain-derived neurotrophic factor levels","volume":"75","author":"Uguz","year":"2013","journal-title":"J. Psychosom. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1007\/s10995-018-2684-x","article-title":"Impact of Maternal Perinatal Anxiety on Social-Emotional Development of 2-Year-Olds, A Prospective Study of Norwegian Mothers and Their Offspring: The Impact of Perinatal Anxiety on Child Development","volume":"23","author":"Polte","year":"2019","journal-title":"Matern. Child Health J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.infbeh.2017.08.008","article-title":"Prenatal anxiety effects: A review","volume":"49","author":"Field","year":"2017","journal-title":"Infant Behav. Dev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1037\/dev0000221","article-title":"Maternal postnatal depression and anxiety and their association with child emotional negativity and behavior problems at two years","volume":"53","author":"Prenoveau","year":"2017","journal-title":"Dev. Psychol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"American Psychiatry Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1192\/bjp.bp.116.187179","article-title":"Prevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis","volume":"210","author":"Dennis","year":"2017","journal-title":"Br. J. Psychiatry"},{"key":"ref_13","unstructured":"Di Nardo, P.A., Brown, T.A., and Barlow, D.H. (1994). Anxiety Disorder Interview Schedule for DSM-IV: Lifetime Version (ADIS-IV-L), Oxford University Press."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/S0887-6185(02)00102-0","article-title":"Stability of worry content in GAD patients: A descriptive study","volume":"16","author":"Constans","year":"2002","journal-title":"J. Anxiety Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s10862-018-9697-z","article-title":"Expression of Generalized Anxiety Disorder across the Lifespan","volume":"41","author":"Correa","year":"2018","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1080\/13607860120065069","article-title":"Worry content reported by older adults with and without generalized anxiety disorder","volume":"5","author":"Diefenbach","year":"2001","journal-title":"Aging Ment. Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1002\/cpp.2413","article-title":"Characterizing the nature of worry in a sample of perinatal women with generalized anxiety disorder","volume":"27","author":"Goldfinger","year":"2019","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_18","unstructured":"Taylor, S. (2019). The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease, Cambridge Scholars Publishing. [1st ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e22002","DOI":"10.2196\/22002","article-title":"Perinatal distress during COVID-19: A thematic analysis of an online parenting forum","volume":"22","author":"Chivers","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Green, S.M., Furtado, M., Inness, B.E., Frey, B.N., and McCabe, R.E. (2021). Characterizing Worry Content and Impact in Pregnant and Postpartum Women with Anxiety Disorders during COVID-19. Clin. Psychol. Psychother.","DOI":"10.1002\/cpp.2703"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jad.2015.11.014","article-title":"Identifying the women at risk of antenatal anxiety and depression: A systematic review","volume":"191","author":"Biaggi","year":"2015","journal-title":"J. Affect. Disord."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.janxdis.2008.07.009","article-title":"Stressful events and support during birth: The effect on anxiety, mood and perceived control","volume":"23","author":"Ford","year":"2009","journal-title":"J. Anxiety Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.jad.2019.02.064","article-title":"Biological and psychosocial predictors of anxiety worsening in the postpartum period: A longitudinal study","volume":"250","author":"Furtado","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.brat.2008.12.004","article-title":"The role of fear of anxiety and intolerance of uncertainty in worry: An experimental manipulation","volume":"47","author":"Buhr","year":"2009","journal-title":"Behav. Res. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.janxdis.2004.12.004","article-title":"Investigating the construct validity of intolerance of uncertainty and its unique relationship with worry","volume":"20","author":"Buhr","year":"2006","journal-title":"J. Anxiety Disord."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1023\/A:1021721332181","article-title":"Understanding Adolescent Worry: The Application of a Cognitive Model","volume":"31","author":"Laugesen","year":"2003","journal-title":"J. Abnorm. Child Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.cpr.2011.05.001","article-title":"A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive\u2013compulsive disorder","volume":"31","author":"Gentes","year":"2011","journal-title":"Clin. Psychol. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1037\/amp0000710","article-title":"Coping and tolerance of uncertainty: Predictors and mediators of mental health during the COVID-19 pandemic","volume":"76","author":"Rettie","year":"2021","journal-title":"Am. Psychol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1007\/s12671-021-01657-x","article-title":"The Indirect Effect of Parental Intolerance of Uncertainty on Perinatal Mental Health via Mindfulness during COVID-19","volume":"12","author":"Sbrilli","year":"2021","journal-title":"Mindfulness"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1177\/0145445500245002","article-title":"Treatment of GAD: Targeting Intolerance of Uncertainty in Two Types of Worry","volume":"24","author":"Dugas","year":"2000","journal-title":"Behav. Modif."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1017\/bec.2021.16","article-title":"Cognitive Behavior Therapy Targeting Intolerance of Uncertainty Versus Selective Serotonin Reuptake Inhibitor for Generalized Anxiety Disorder: A Randomized Clinical Trial","volume":"38","author":"Zemestani","year":"2021","journal-title":"Behav. Chang."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"196","DOI":"10.4306\/pi.2016.13.2.196","article-title":"Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder","volume":"13","author":"Kim","year":"2016","journal-title":"Psychiatry Investig."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Green, S.M., Frey, B.N., Donegan, E., and McCabe, R.E. (2019). Cognitive Behavioral Therapy for Anxiety and Depression during Pregnancy and Beyond: How to Manage Symptoms and Maximize Well-Being, Routledge. [1st ed.].","DOI":"10.4324\/9781315452494"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1177\/0004867419898528","article-title":"Cognitive behavioral therapy for perinatal anxiety: A randomized controlled trial","volume":"54","author":"Green","year":"2020","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Caropreso, L., Saliba, S., Hasegawa, L., Lawrence, J., Davey, C.J., and Frey, B.N. (2020). Quality assurance assessment of a specialized perinatal mental health clinic. BMC Pregnancy Childbirth, 20.","DOI":"10.1186\/s12884-020-03174-6"},{"key":"ref_36","unstructured":"Sheehan, D.V. (2021, December 19). Mini International Neuropsychiatric Interview (MINI), English Version 7.0.2 for DSM-5. Available online: https:\/\/harmresearch.org\/index.php\/product\/mini-international-neuropsychiatric-interview-mini-7-0-2-4\/."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.cbpra.2018.07.007","article-title":"Behavioral Experiments for Intolerance of Uncertainty: Challenging the Unknown in the Treatment of Generalized Anxiety Disorder","volume":"26","author":"Hebert","year":"2018","journal-title":"Cogn. Behav. Pract."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.cbpra.2012.09.001","article-title":"Cognitive Behavior Therapy Targeting Intolerance of Uncertainty: Application to a Clinical Case of Generalized Anxiety Disorder","volume":"20","author":"Robichaud","year":"2012","journal-title":"Cogn. Behav. Pract."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/0005-7967(90)90135-6","article-title":"Development and validation of the penn state worry questionnaire","volume":"28","author":"Meyer","year":"1990","journal-title":"Behav. Res. Ther."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.jbtep.2003.09.001","article-title":"Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: A receiver operating characteristic analysis","volume":"34","author":"Fresco","year":"2003","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/0005-7967(92)90093-V","article-title":"Psychometric properties of the Penn state worry questionnaire in a clinical anxiety disorders sample","volume":"30","author":"Brown","year":"1992","journal-title":"Behav. Res. Ther."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jad.2016.03.008","article-title":"Pregnancy-related anxiety: Evidence of distinct clinical significance from a prospective longitudinal study","volume":"197","author":"Blackmore","year":"2016","journal-title":"J. Affect. Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1089\/jwh.2010.2371","article-title":"Relationships among Depression, Anxiety, and Insomnia Symptoms in Perinatal Women Seeking Mental Health Treatment","volume":"20","author":"Swanson","year":"2011","journal-title":"J. Women\u2019s Health"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S0005-7967(01)00092-4","article-title":"The intolerance of uncertainty scale: Psychometric properties of the English version","volume":"40","author":"Buhr","year":"2002","journal-title":"Behav. Res. Ther."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/0191-8869(94)90048-5","article-title":"Why do people worry?","volume":"17","author":"Freeston","year":"1994","journal-title":"Pers. Individ. Differ."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-021-04296-1","article-title":"Validation of the intolerance of uncertainty scale as a screening tool for perinatal anxiety","volume":"21","author":"Furtado","year":"2021","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of Postnatal Depression. Development of the 10-Item Edinburgh Postnatal Depression Scale","volume":"150","author":"Cox","year":"1987","journal-title":"Br. J. Psychiatry"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/02646839008403615","article-title":"Screening for depression during pregnancy with the edinburgh depression scale (EDDS)","volume":"8","author":"Murray","year":"1990","journal-title":"J. Reprod. Infant Psychol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s00737-006-0152-x","article-title":"Variability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale\u2014implications for clinical and research practice","volume":"9","author":"Matthey","year":"2006","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/0149-7189(79)90094-6","article-title":"Assessment of client\/patient satisfaction: Development of a general scale","volume":"2","author":"Larsen","year":"1979","journal-title":"Eval. Program Plan."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/0149-7189(81)90004-5","article-title":"Artifact in client satisfaction assessment: Experience in community mental health settings","volume":"4","author":"LeVois","year":"1981","journal-title":"Eval. Program Plan."},{"key":"ref_53","unstructured":"IBM Corp. (2015). IBM SPSS Statistics for Windows, Version 23, IBM Corp."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1016\/j.jad.2020.07.081","article-title":"Maternal psychological distress & mental health service use during the COVID-19 pandemic","volume":"276","author":"Cameron","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"127","DOI":"10.2214\/AJR.20.23072","article-title":"Pregnancy and Perinatal Outcomes of Women With Coronavirus Disease (COVID-19) Pneumonia: A Preliminary Analysis","volume":"215","author":"Liu","year":"2020","journal-title":"Am. J. Roentgenol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.cpr.2014.01.002","article-title":"Psychological treatment of generalized anxiety disorder: A meta-analysis","volume":"34","author":"Cuijpers","year":"2014","journal-title":"Clin. Psychol. Rev."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/16506073.2018.1560358","article-title":"Psychological and pharmacological treatments for generalized anxiety disorder (GAD): A meta-analysis of randomized controlled trials","volume":"49","author":"Carl","year":"2019","journal-title":"Cogn. Behav. Ther."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.jad.2018.09.057","article-title":"A randomized controlled trial of \u2018MUMentum Pregnancy\u2019: Internet-delivered cognitive behavioral therapy program for antenatal anxiety and depression","volume":"243","author":"Loughnan","year":"2018","journal-title":"J. Affect. Disord."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1037\/a0028132","article-title":"Generalized anxiety disorder: A comparison of symptom change in adults receiving cognitive-behavioral therapy or applied relaxation","volume":"80","author":"Donegan","year":"2012","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1017\/bec.2018.13","article-title":"The Mediating Relationship between Maladaptive Behaviours, Cognitive Factors, and Generalised Anxiety Disorder Symptoms","volume":"35","author":"Mahoney","year":"2018","journal-title":"Behav. Chang."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.jpsychires.2018.11.016","article-title":"The symptoms at the center: Examining the comorbidity of posttraumatic stress disorder, generalized anxiety disorder, and depression with network analysis","volume":"109","author":"Price","year":"2018","journal-title":"J. Psychiatr. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1017\/S0033291706009640","article-title":"Generalized anxiety disorder and depression: Childhood risk factors in a birth cohort followed to age 32","volume":"37","author":"Moffitt","year":"2007","journal-title":"Psychol. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"10","DOI":"10.4088\/JCP.s.7002.02","article-title":"Generalized anxiety disorder and psychiatric comorbidities such as depression, bipolar disorder, and substance abuse","volume":"70","author":"Simon","year":"2009","journal-title":"J. Clin. Psychiatry"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1001\/jamapediatrics.2020.2910","article-title":"Association Between Maternal Perinatal Depression and Anxiety and Child and Adolescent Development: A Meta-analysis","volume":"174","author":"Rogers","year":"2020","journal-title":"JAMA Pediatr."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/1\/209\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:56:35Z","timestamp":1760169395000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/1\/209"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,31]]},"references-count":64,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["jcm11010209"],"URL":"https:\/\/doi.org\/10.3390\/jcm11010209","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,31]]}}}