PMH-C Anxiety Disorders in Pregnancy 4

Question 1

A pregnant woman describes intense fear of childbirth, avoidance of childbirth education classes, and requests an elective cesarean section solely due to fear.
This presentation is most consistent with:

Accepted Answer

Tokophobia

Answer

Adjustment disorder

Answer

Specific phobia, blood-injection-injury type

Answer

Agoraphobia

Question 2

Which benzodiazepine characteristic is most important when considering short-term use for acute anxiety in a pregnant patient near term?

Accepted Answer

Half-life, because long-acting agents accumulate in the neonate

Answer

Receptor selectivity, because GABA-A selectivity reduces teratogenicity

Answer

Protein binding, because high binding prevents placental transfer

Answer

Route of administration, as oral forms do not cross the placenta

Question 3

A woman with social anxiety disorder is pregnant and relies on avoidance of prenatal group classes, pushing them to see only one provider. What complication of untreated social anxiety is most relevant in the perinatal context?

Accepted Answer

Social isolation and reduced social support, increasing postpartum depression risk

Answer

Increased risk of gestational diabetes

Answer

Elevated systolic blood pressure from social stress

Answer

Preterm labor triggered by interpersonal conflict

Question 4

Which statement best describes the relationship between prenatal anxiety and postpartum depression?

Accepted Answer

Prenatal anxiety is one of the strongest predictors of postpartum depression

Answer

They are unrelated conditions with distinct risk factor profiles

Answer

Postpartum depression always precedes prenatal anxiety in the same pregnancy

Answer

Prenatal anxiety only predicts postpartum anxiety, not depression

Question 5

A PMH-C clinician recommends mindfulness-based cognitive therapy (MBCT) to a pregnant patient with recurrent anxiety. What is the primary mechanism of action of MBCT?

Accepted Answer

Developing non-judgmental awareness of thoughts to break the anxiety rumination cycle

Answer

Exposure and response prevention to feared stimuli

Answer

Behavioral activation to counter anxiety-driven withdrawal

Answer

Systematic desensitization through progressive muscle relaxation

Question 6

When assessing a pregnant immigrant woman for anxiety, which culturally sensitive consideration is most critical?

Accepted Answer

Recognizing that somatic presentations of anxiety may predominate in some cultural contexts

Answer

Assuming anxiety is less prevalent in non-Western cultures

Answer

Applying Western diagnostic criteria without cultural adaptation

Answer

Avoiding discussion of anxiety to respect cultural norms about mental health

Question 7

A pregnant woman with PTSD from a prior traumatic birth reports that her current pregnancy has triggered severe intrusive re-experiencing. Which specific CBT technique is most evidence-based for trauma-related intrusive symptoms?

Accepted Answer

Trauma-focused cognitive restructuring and prolonged exposure

Answer

Behavioral activation

Answer

Worry time scheduling

Answer

Interoceptive exposure