Daily dynamics of suicide risk, dysregulation, and sleep disruption across the transition to parenthood

为人父母过渡期间自杀风险、调节失调和睡眠中断的日常动态

• 批准号: 10383139
• 负责人: Parisa Kaliush
• 金额: $ 3.79万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-16 至 2022-08-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10383139
• 关键词: Address; Attention; Behavior; Biological Models; Birth; Cause of Death; Cessation of life; Child; Clinical; Complex; Coupling; Diagnostic; Distress; Emotions; Enrollment; Exhibits; Family; Feeling suicidal; Female of child bearing age; Foundations; Health; Individual; Link; Longitudinal Studies; Maternal Mortality; Measurement; Measures; Mental Health; Mental disorders; Methodology; Methods; Mothers; National Institute of Mental Health; Neurobiology; Outcome; Overdose; Parents; Participant; Perinatal; Persons; Pharmaceutical Preparations; Population; Postpartum Depression; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Prevention; Public Health; Research; Research Design; Research Personnel; Research Support; Risk Behaviors; Risk Factors; Sampling; Self-Injurious Behavior; Sleep; Sleep disturbances; Sleeplessness; Strategic Planning; Suicide; Suicide attempt; Surveys; Systems Theory; Testing; Thinking; Third Pregnancy Trimester; Time; Woman; Wrist; actigraphy; aged; depressive symptoms; design; dynamic system; emotion dysregulation; experience; improved; innovation; neglect; perinatal mental health; perinatal period; poor sleep; prevent; recruit; sleep quality; suicidal morbidity; suicidal risk; suicide rate; therapy design; virtual

PROJECT SUMMARY Suicide accounts for 20-30% of maternal postpartum deaths, and is the second leading cause of death among new mothers. Despite this national health crisis, current suicide research sorely neglects samples of pregnant and postpartum women. There is urgent need to identify factors contributing to suicide risk in this population; however, current perinatal research is limited by single-diagnostic approaches and poor measurement of self- injurious thoughts and behaviors (SITBs). In addition, suicide research, in general, is in dire need of methodological advancement, as predictive ability for suicide attempts has not improved. This project will advance these fields of research by implementing an innovative multiple time-scale design that captures repeated measures of women’s SITBs and relevant risk factors across the perinatal period. Specifically, sleep disturbances (e.g., poor sleep quality, frequent nightly awakenings) and emotion dysregulation will be measured, as they are well-established transdiagnostic risk factors for SITBs that are highly relevant across the perinatal period. Pregnant women aged 18 to 39 who are enrolled in a parent R01 study (R01MH119070) will be recruited for this project. They will wear wrist actigraphs for objective sleep-wake measurements and complete brief morning and evening surveys on their sleep, emotion dysregulation, and SITBs for 7 days during the third trimester, 6 weeks postpartum, and 4 months postpartum. These three time points are meaningful across the perinatal period, as sleep outcomes decrease substantially by third trimester, depressive symptoms often develop around 6 weeks postpartum, and there is virtually no research on women’s mental health beyond 3 months postpartum, despite evidence that most maternal self-harm deaths occur between 9 and 12 months postpartum. This short-term longitudinal study will use dynamical systems modeling to illuminate temporal relations between women’s sleep, emotion dysregulation, and SITBs (Aims 1 and 2), as well as how sleep and emotion dysregulation influence SITBs over time (Aim 3). Dynamical systems modeling is nascent in suicide and perinatal mental health research, and offers an innovative approach to characterize how constructs interact and change over time. Moreover, this project’s multiple time-scale design affords a critical opportunity to uncover how the birth of a child may change the dynamics between these constructs. Given rising rates of suicide among women of childbearing age as well as devastating consequences of maternal death on children and families, this project addresses an urgent need to understand the emergence of suicidality across the transition to parenthood. When the aims of this project are realized, there will be a foundation for future research and interventions designed to reduce perinatal distress and maternal self-harm-related deaths.

项目摘要 自杀占产妇产后死亡的20-30%，是产妇死亡的第二大原因。 新妈妈尽管这是一场全国性的健康危机，但目前的自杀研究严重忽视了怀孕妇女的样本。 产后妇女。迫切需要确定导致这一人群自杀风险的因素; 然而，目前的围产期研究受到单一诊断方法和自我测量不良的限制， 有害的想法和行为（SITBs）。此外，自杀研究，一般来说，是迫切需要的， 方法的进步，因为自杀企图的预测能力没有提高。该项目将 通过实施创新的多时间尺度设计来推进这些研究领域， 反复测量妇女的SITB和围产期的相关风险因素。特别是睡眠 干扰（例如，睡眠质量差、频繁的夜间醒来）和情绪失调将被测量， 因为它们是SITB的公认跨诊断风险因素，与围产期高度相关， 期将招募入组母研究R 01（R 01 MH 119070）的18 - 39岁妊娠女性 为这个项目。他们将佩戴手腕活动记录仪进行客观的睡眠-觉醒测量并完成简报 在第三个月期间，对他们的睡眠，情绪失调和SITB进行了7天的早晚调查 妊娠期、产后6周和产后4个月。这三个时间点在整个 围产期，由于睡眠结果在妊娠晚期大幅下降，抑郁症状往往 产后6周左右发展，几乎没有关于妇女心理健康的研究超过3周。 尽管有证据表明，大多数产妇的自残死亡发生在产后9至12个月之间， 产后这项短期的纵向研究将使用动态系统建模来阐明时间 女性睡眠、情绪失调和SITBs之间的关系（目的1和2），以及睡眠和 情绪失调随时间影响SITB（目标3）。动态系统建模在自杀和 围产期心理健康研究，并提供了一个创新的方法来表征如何结构相互作用， 随着时间的推移而改变。此外，该项目的多时间尺度设计提供了一个关键的机会， 孩子的出生如何改变这些结构之间的动态。鉴于自杀率的上升， 这一问题不仅涉及育龄妇女，而且涉及孕产妇死亡对儿童和家庭造成的破坏性后果， 该项目解决了一个迫切需要了解自杀的出现在过渡到父母。 当这个项目的目标实现后，将为今后的研究和干预奠定基础 旨在减少围产期痛苦和产妇自残相关死亡。