Reducing Fetal Exposure to Maternal Depression to Improve Infant Risk Mechanisms

点击翻译按钮获取中文摘要

Project Summary/Abstract Exposure to maternal depressive symptoms is one of the most well established risk factors for the development of later child psychopathology. Accumulating evidence from naturalistic observational studies documents that fetal exposure to maternal depressive symptoms is associated with risk for later child mental health problems. Maternal depression is one of the most common prenatal complications with approximately 40% of women experiencing elevated levels of depressive symptoms. The majority of past research has been correlational, so potential causal conclusions have been limited. This project will break new ground by testing the hypothesis that manipulating maternal depressive symptoms will benefit infant outcomes. In this project, maternal depressive symptoms will be reduced using brief interpersonal therapy (IPT), a well-established and efficacious treatment, and testing whether this reduction leads to an improvement in the development of infant mechanisms associated with risk for later psychopathology. Consistent with NIMH's priority of Research Domain Criteria (RDoC)-based processes, we will assess infants with multiple measures that assess the constructs of potential threat (“anxiety”) from the Negative Valence System and cognitive (effortful) control from the Cognitive System. We propose to assess 300 pregnant women who report elevated levels of depressive symptoms and their infants. Prior to the intervention, maternal measures will be collected. Then half of the women will be randomized to receive IPT and the other half will receive enhanced usual care. After completion of the intervention, maternal measures will be collected longitudinally through 14 months postpartum. Infants will be evaluated at birth and at 7- and 14-months corrected age. Infants will be assessed across four units of analysis (brain structure and function, physiology, behavior, and maternal-report).