Exploring a Risk Phenotype for Maternal Distress Characterized by Regulatory Focus

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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.