Exploring a Risk Phenotype for Maternal Distress Characterized by Regulatory Focus

项目总结 产后窘迫症状的高发生率(15%)和低缓解率(30%-50%)都表明 有必要更多地研究与产妇痛苦增加相关的潜在机制 照顾不足。严重的产妇痛苦症状将继续造成严重的发病率，并引发 糟糕的儿童健康结果，除非我们发起全系统范围的护士和其他医疗保健方式的改变 专业人士理解和识别产妇痛苦的指标。先前的研究已经确定 母亲的痛苦症状升高(如易怒和快感缺乏)表现为神经功能受抑。 奖励责任感。然而，很少有研究考察奖励对损失的响应性和 照看行为。更少的研究要求女性描述她们追求目标的经历 在产后期和被认为是母亲的功能能力。为了解决这一研究差距， 拟议的研究将应用调节焦点理论将异常奖励反应和破坏性反应联系起来 用抑郁和焦虑问卷评估对特定痛苦症状集的照顾行为 症状自评量表(IDAS)。AIM 1将使用回顾的二次分析来关联功能磁共振成像 用IDAS评分对数据进行成像，以确定与受抑制奖赏相关的不同症状集 责任感。目标2将使用前瞻性的混合方法分析来关联母亲的照料行为 来自12位母亲的IDAS评分和定性访谈。探索性目标3将解释 综合目标1和目标2的研究结果，提出母体痛苦的初始风险表型。这是第一步 开发一种风险表型将指导未来的研究，以最大限度地改善对女性的早期发现 在产后期间容易出现衰弱的窘迫症状。建议进行的研究 以及相关的研究培训为护理创新计划提供了全面的基础 研究集中在照顾者-孩子关系的双向性质上，因为它与监管焦点有关 理论，特别是加强母亲的自我调节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.