Exploring a Risk Phenotype for Maternal Distress Characterized by Regulatory Focus

探索以监管焦点为特征的孕产妇痛苦风险表型

基本信息

批准号：
10388878
负责人：
Elisabeth Bernhardt
金额：
$ 3.68万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-01-13 至 2024-05-12
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10388878
关键词：
Activities of Daily Living Address Anhedonia Behavior Behavioral Brain Caregivers Caring Child Child Health Child Rearing Childbirth Clinical assessments Code Cognitive Data Developmental Disabilities Disease remission Distress Early Diagnosis Emotional Equipment and supply inventories Estrogens Foundations Functional Magnetic Resonance Imaging Functional disorder Future Goals Health Professional Hormonal Hormones Image Impairment Incidence Infant Infant Development Informal Social Control Interview Lead Left Link Measures Methods Modeling Moods Morbidity - disease rate Mother-Child Relations Mothers Nature Neural Pathways Neurologic Neurons Nurses Nursing Research Outcome Participant Pathway interactions Patient Self-Report Pattern Phase Phenotype Play Postdoctoral Fellow Postpartum Period Prefrontal Cortex Prevention Prevention strategy Process Progesterone Research Research Training Rewards Risk Role Self Management Severities Sleep Symptoms System Time Variant Ventral Striatum Withdrawal Woman Work anxiety symptoms associated symptom caregiving daily functioning depressive symptoms digital disabling symptom effective therapy experience financial incentive improved innovation maternal caregiving motherhood neural correlate novel strategies postpartum care prevent programs prospective relating to nervous system response secondary analysis stressor symptom management symptom science theories therapy development

项目摘要

PROJECT SUMMARY Both high incidence (i.e., 15%) and low remission rate (i.e., 30-50%) of postpartum distress symptoms indicate a need for more research on the underlying mechanisms associated with elevated maternal distress and caregiving deficits. Severe symptoms of maternal distress will continue to inflict significant morbidity and elicit poor child health outcomes unless we initiate a system-wide change in how nurses and other healthcare professionals understand and recognize indicators of maternal distress. Prior research has determined that mothers with elevated distress symptoms (e.g., irritability and anhedonia) display suppressed neurological reward responsivity. However, few studies have examined the role of reward responsivity to loss and caregiving behaviors. Even fewer studies have asked women to describe their experience with goal pursuit during the postpartum period and perceived functional ability as a mother. To address this research gap, the proposed study will apply the Regulatory Focus Theory to link both aberrant reward responses and disruptive caregiving behaviors to specific distress symptom sets assessed with the Inventory of Depression and Anxiety Symptoms (IDAS) self-report measure. Aim 1 will use a retrospective, secondary analysis to correlate fMRI imaging data with IDAS scores to determine distinct symptom sets that are associated with suppressed reward responsivity. Aim 2 will use prospective, mixed-methods analyses to correlate maternal caregiving behaviors with IDAS scores and qualitative interviews from a subset of 12 mothers. Exploratory Aim 3 will interpretively synthesize findings from Aims 1 and 2 to propose an initial risk phenotype for maternal distress. This initial step toward developing a risk phenotype will guide future research to improve early detection of women most vulnerable to developing debilitating symptoms of distress during the postpartum period. The proposed study and associated research training provide a comprehensive foundation for an innovative program of nursing research focused on the bidirectional nature of the caregiver-child relationship as it relates to Regulatory Focus Theory, specifically whether enhancing maternal self-regulation can prevent child development disorders.

项目摘要产后痛苦症状的高发病率（即15％）和低缓解率（即30-50％）表明需要更多地研究与孕产妇困扰和较高的基本机制和护理缺陷。孕产妇困扰的严重症状将继续引起明显的发病率并引起儿童健康结果差，除非我们在护士和其他医疗保健方面启动全系统变化专业人士了解并认识到产妇困扰的指标。先前的研究已经确定遇险症状升高的母亲（例如，烦躁和抗心nhe）表现出抑制神经系统奖励响应能力。但是，很少有研究研究奖励对损失的响应能力的作用和护理行为。甚至更少的研究要求妇女描述自己的目标追求经验在产后时期，并认为作为母亲的功能能力。为了解决这一研究差距拟议的研究将应用监管重点理论来连接异常奖励反应和破坏性通过抑郁和焦虑量评估的特定困扰症状集的护理行为症状（IDA）自我报告措施。 AIM 1将使用回顾性的二级分析来关联fMRI 具有IDAS分数的成像数据，以确定与被抑制奖励相关的不同症状集反应性。 AIM 2将使用预期的混合方法分析来关联孕产妇的护理行为来自12位母亲的子集的IDA分数和定性访谈。探索目标3将解释从目标1和2中综合发现，以提出针对孕产妇的初始风险表型。这首先发展风险表型将指导未来的研究以改善对女性的早期发现在产后时期很容易发生衰弱的困扰症状。拟议的研究相关的研究培训为护理创新计划提供了全面的基础研究重点是照顾者与儿童关系的双向性质，因为它与监管重点有关理论，特别是增强母体自我调节可以预防儿童发育障碍。