Newborn Screening and the Parent-Infant Relationships

这位候选人正在提交一份来自NICHD的K23奖项的提案，该奖项的短期职业发展目标是提高她的研究技能，长期目标是开发一项研究计划，其中包括旨在评估慢性病儿童及其家庭心理社会干预效果的临床试验。为了实现这些目标，她提出了一项职业发展计划，其中包括参加威斯康星大学医学院提供的临床研究人员预备计划(CIPP)。拟议的研究项目将评估新生儿筛查和诊断对亲婴关系的影响；研究可能导致亲婴关系障碍的相互作用机制；并确定可能在亲婴关系质量中起中介作用的父母、婴儿和亲婴二元变量。将比较四组：a)通过新生儿筛查确诊为CF的婴儿家庭(CF-D)，b)通过新生儿筛查确定为杂合子CF突变携带者的家庭(CF-C)，c)通过新生儿筛查诊断为先天性甲状腺功能减退(CH)的婴儿家庭(CH)，以及d)筛查结果正常的健康婴儿(H)家庭。设计将由多模式方法组成，包括经验性验证的自我报告测量、观察测量和图表审查。将收集有关父母、婴儿和亲子互动变量的数据。自变量将由父母的任务导向行为水平和通过观察法测量的与婴儿互动的情绪反应组成。主要的因变量将是通过父母自我报告和观察法测量的父母-婴儿依恋关系的质量。中介因素包括父母的心理症状、压力和应对方式，以及婴儿的气质、发育状况和疾病严重程度。将在一年内跟踪家庭并收集数据，以记录婴儿第一年期间亲子关系的变化。人口统计变量将受到统计控制。这项研究将为这一遗传高危人群的干预研究提供重要的数据。

The candidate is submitting a proposal for a K23 Award from the NICHD with a short-term career development goal of enhancing her research skills and a long-term goal of developing a program of research that includes clinical trials designed to evaluate the efficacy of psychosocial interventions for children with chronic illness and their families. To meet these goals, she proposes a career development plan that includes participation in the Clinical Investigator Preparatory Program (CIPP) offered through the University of Wisconsin Medical School. The proposed research project will evaluate the impact of newborn screening and diagnosis on the parent-infant relationship; examine the interactional mechanism that may contribute to a parent-infant relational disturbance; and identify parent, infant, and parent-infant dyadic variables that may serve as mediating factors in the quality of the parent-infant relationship. Four groups will be compared: a) families with infants who have CF diagnosed through newborn screening (CF-D), b) families with infants who are heterozygote CF mutation carriers identified through newborn screening (CF-C), c), families with infants who have congenital hypothyroidism (CH) diagnosed through newborn screening (CH), and d) families who have healthy infants (H) with normal screening results. The design will consist of multi-modal methods including empirically validated self- report measures, observational measures, and chart review. Data will be collected on parent, infant, and parent-infant interactional variables. Independent variables will consist of parents' level of task-oriented behaviors and emotional responsiveness in interactions with their infants as measured by an observational method. The primary dependent variable will be the quality of the parent-infant attachment relationship as measured by parental self-report and an observational method. Mediating factors will include parental psychological symptoms, stress, and coping style, as well as infant temperament, developmental status, and illness severity. Families will be followed and data collected over one year to document parent-child relationship changes over the infant's first year. Demographic variables will be controlled statistically. This study will provide important data for development of an intervention study for this genetically at risk population.