Reducing Fetal Exposure to Maternal Depression to Improve Infant Risk Mechanisms

减少胎儿接触母亲抑郁症的机会，改善婴儿风险机制

基本信息

批准号：
9914375
负责人：
Elysia Poggi Davis
金额：
$ 69.09万
依托单位：
UNIVERSITY OF DENVER (COLORADO SEMINARY)
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-04-07 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9914375
关键词：
Affect Age American Amygdaloid structure Anxiety Anxiety Disorders Area Attention Behavior Birth Brain Brain region Child Child Development Child Mental Health Childhood Clinical Cognitive Communities Data Depressed mood Development Disease Emotional Exposure to Fetus Fiber Functional Magnetic Resonance Imaging Hippocampus (Brain)Hydrocortisone Impairment Infant Infant Development Intervention Knowledge Lead Life Link Longevity Magnetic Resonance Imaging Measures Medical center Mental Depression Mental Health Meta-Analysis Mood Disorders National Institute of Mental Health Negative Valence Neurologic Observational Study Occupational Outcome Physiology Postpartum Period Prefrontal Cortex Pregnancy Pregnant Women Process Psychopathology Public Health Randomized Randomized Clinical Trials Recording of previous events Recovery Regulation Reporting Research Research Domain Criteria Research Priority Rest Risk Risk Factors Structure System Testing Thick Thinness Woman antepartum depression base behavior observation brain circuitry cognitive control cognitive system connectome depressive symptoms design ethnic diversity experience fetal improved infancy infant outcome innovation interpersonal therapy lifetime risk maternal depression offspring prenatal prenatal exposure recruit social socioeconomics therapy development translational impact treatment as usual visual tracking white matter

项目摘要

Project Summary/Abstract Exposure to maternal depressive symptoms is one of the most well established risk factors for the development of later child psychopathology. Accumulating evidence from naturalistic observational studies documents that fetal exposure to maternal depressive symptoms is associated with risk for later child mental health problems. Maternal depression is one of the most common prenatal complications with approximately 40% of women experiencing elevated levels of depressive symptoms. The majority of past research has been correlational, so potential causal conclusions have been limited. This project will break new ground by testing the hypothesis that manipulating maternal depressive symptoms will benefit infant outcomes. In this project, maternal depressive symptoms will be reduced using brief interpersonal therapy (IPT), a well-established and efficacious treatment, and testing whether this reduction leads to an improvement in the development of infant mechanisms associated with risk for later psychopathology. Consistent with NIMH's priority of Research Domain Criteria (RDoC)-based processes, we will assess infants with multiple measures that assess the constructs of potential threat (“anxiety”) from the Negative Valence System and cognitive (effortful) control from the Cognitive System. We propose to assess 300 pregnant women who report elevated levels of depressive symptoms and their infants. Prior to the intervention, maternal measures will be collected. Then half of the women will be randomized to receive IPT and the other half will receive enhanced usual care. After completion of the intervention, maternal measures will be collected longitudinally through 14 months postpartum. Infants will be evaluated at birth and at 7- and 14-months corrected age. Infants will be assessed across four units of analysis (brain structure and function, physiology, behavior, and maternal-report).

项目摘要/摘要暴露于产妇抑郁症状是最确立的风险因素之一后来的儿童心理病理学的发展。从自然主义观察研究中积累证据胎儿暴露于产妇抑郁症状的文件与后来儿童精神的风险有关健康问题。孕产妇抑郁是最常见的产前并发症之一，大约 40％的女性患有抑郁症状升高。过去的大多数研究是相关性，因此潜在的因果结论受到限制。该项目将通过测试破裂操纵遗传性抑郁症状的假设将使婴儿结局受益。在这个项目中，使用简短的人际疗法（IPT），良好的和公认的，有效的治疗以及测试这种减少是否导致婴儿发展的改善与后来的心理病理风险相关的机制。与NIMH的研究优先级一致域标准（RDOC）基于过程，我们将通过多种措施评估婴儿负面价系统和认知（努力）控制的潜在威胁（“焦虑”）的结构认知系统。我们建议评估300名孕妇，这些孕妇报告抑郁水平升高症状及其婴儿。在干预之前，将收集产妇措施。然后一半妇女将被随机接受IPT，另一半将获得增强的常规护理。完成后在干预措施中，产妇措施将在产后14个月之前纵向收集。婴儿将在出生时以及7个月和14个月的校正年龄进行评估。婴儿将在四个单位的评估分析（大脑结构和功能，生理，行为和母体报告）。