Exploring a Risk Phenotype for Maternal Distress Characterized by Regulatory Focus

项目摘要 两者都是高发病率（即，15%）和低缓解率（即，30-50%）的产后窘迫症状表明 需要更多地研究与产妇痛苦增加相关的潜在机制， 减少赤字。产妇痛苦的严重症状将继续造成严重的发病率， 除非我们在护士和其他医疗保健方面发起全系统范围的变革，否则儿童健康结果会很差 专业人员理解并认识到产妇痛苦的指标。先前的研究已经确定， 具有升高的痛苦症状的母亲（例如，易激惹和快感缺乏）显示神经抑制 奖励响应性。然而，很少有研究探讨奖励反应对损失的作用， 行为举止。更少的研究要求女性描述她们在追求目标方面的经历 在产后期间和作为母亲的感知功能能力。为了弥补这一研究空白， 拟议的研究将应用调节焦点理论来联系异常的奖励反应和破坏性的 用抑郁和焦虑量表评估对特定苦恼症状的回避行为 症状（IDAS）自我报告测量。目标1将使用回顾性二次分析来关联fMRI 使用IDAS评分的成像数据，以确定与抑制奖励相关的不同症状集 响应性目标2将使用前瞻性的混合方法分析母亲的生育行为 与IDAS评分和定性访谈从一个子集的12位母亲。探索性目标3将解释 综合目标1和2的发现，提出产妇痛苦的初始风险表型。该初始步骤 发展风险表型将指导未来的研究，以提高妇女的早期发现最 在产后期间容易出现使人衰弱的痛苦症状。拟定研究 和相关的研究培训提供了一个全面的基础护理创新计划 研究的重点是父母与子女关系的双向性，因为它与监管焦点有关 理论，特别是增强母亲的自我调节能力是否可以预防儿童发育障碍。

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.