Investigating the effects of depression on contraceptive behaviors

描述（由申请人提供）：在18-24岁的女性中，68%的怀孕是意外的，在这个年龄段的美国女性中，大约有四分之一的人在过去的一年中有过抑郁发作。心理学和生殖健康交叉领域的许多研究都把抑郁症作为生殖健康经历（如分娩、意外怀孕、不孕症或使用避孕药具）的结果。相比之下，这个K01指导研究科学家发展奖侧重于将抑郁症作为年轻女性意外怀孕的前兆的概念，因为使用避孕需要知识、动机和抑郁个体可能缺乏的能动性。为了更好地理解生育理论并将人口统计学观点整合到我的工作中，我建议以下职业发展活动：1)获得人口和人口统计学研究和方法方面的正式培训，2)对抑郁症在意外怀孕中的作用进行合理的概念化，3)扩展我的统计技能，包括纵向和中介分析，4)学习并获得定性方法的经验。这些研究活动是对这些培训目标的补充，它们是：1)调查抑郁对避孕行为的影响程度，如避孕方法的选择、避孕方法的使用模式、避孕方法的停止和不一致的使用；2)使用定量和定性的方法来研究抑郁影响避孕行为的潜在机制；3)开展前瞻性队列研究，探讨个体内部抑郁变化对避孕行为变化的影响程度和机制，以及其他重要解释因素。这些努力将受益于由世界知名学者组成的顾问委员会，包括主要导师Nancy Adler博士，共同导师Jennifer Johnson-Hanks博士，科学顾问James Trussell博士和科学顾问Tina Raine-Bennett博士。此外，教师顾问Chuck McCulloch博士，Owen Wolkowitz博士和Judith Barker博士将分别提供统计分析技术，抑郁症临床方面和定性方法方面的专业知识。加州大学旧金山分校精神病学系将为这些活动提供基础设施支持。本K01所建议的培训及研究活动将有助

DESCRIPTION (provided by applicant): Sixty-eight percent of pregnancies among women ages 18-24 are unintended, and approximately one quarter of U.S. women in this age group have had a depressive episode in the past year. Much research at the intersection of psychology and reproductive health has focused on depression as an outcome of reproductive health experiences such as childbirth, unintended pregnancy, infertility, or contraceptive use. In contrast, this K01 Mentored Research Scientist Development Award focuses on conceptualizing depression as a precursor to unintended pregnancy among young women because using contraception requires knowledge, motivation, and a sense of agency that depressed individuals may lack. To better understand theories of fertility and to integrate demographic perspectives into my work, I propose the following career development activities: 1) obtain formal training in population and demographic research and methods, 2) develop a sound conceptualization of the role of depression in unintended pregnancy, 3) extend my statistical skill set to include longitudinal and mediational analyses, and 4) learn about and gain experience with qualitative methods. The research activities complement these training goals and are: 1) to investigate the extent to which depression influences contraceptive behaviors such as choice of contraceptive method, contraceptive use patterns, method discontinuation, and inconsistent use, 2) to use quantitative and qualitative methods to examine potential mechanisms by which depression influences contraceptive behaviors, and 3) to develop and pilot a prospective cohort study to investigate the extent to which and mechanisms by which intra-individual changes in depression influence changes in contraceptive behaviors relative to other significant explanatory factors. These endeavors will benefit from an advisory board comprised of world-renown scholars including primary mentor Nancy Adler, PhD, co-mentor Jennifer Johnson-Hanks, PhD, scientific advisor James Trussell, PhD, and scientific advisor Tina Raine-Bennett, MD. In addition, faculty consultants Chuck McCulloch, PhD, Owen Wolkowitz, MD, and Judith Barker, PhD will provide expertise in statistical analysis techniques, clinical aspects of depression, and qualitative methods, respectively. The UCSF Department of Psychiatry will provide the infrastructure to support these activities. The training and research activities proposed in this K01 will facilitate my transition to an independent investigator who takes an interdisciplinary and multi-method approach to understanding psychological aspects of reproductive health and will broaden our understanding of what leads to unintended pregnancy.