Effects of maternal opioid use disorder on neural and behavioral indicators of caregiving

项目摘要 阿片类药物使用障碍（OUD）是一个主要的公共卫生问题，具有高成本负担和多方面的风险。 代的不良后果。特别是，怀孕期间和产后的OUD发生率 在过去20年中翻了两番，在敏感时期对孕产妇死亡构成严重威胁。 婴儿期虽然现有的研究指出母亲成瘾对养育行为的负面影响， 儿童结局--包括后代后期物质使用问题的风险增加--对 特别是母体对阿片类药物成瘾的影响。这种研究上的差距延伸到我们对 神经机制的基础上的行为，这还有待于检查母亲与OUD。 根据NIDA的战略目标1.3和4.1，拟议的多方法研究的总体目标 这项研究旨在提供关于母体OUD在神经， 行为和自我报告的分析水平。作为现有母体阿片类药物使用轨迹研究的补充 怀孕后，本研究将评估产后5个月的神经和行为发育指标， 在接受药物辅助的母亲中，产后6个月婴儿的社会情感发育 治疗（MAT）OUD和人口统计学匹配的对照母亲没有OUD。目标1将利用事件- 相关电位（ERP）检查OUD母亲对婴儿线索的神经反应差异， 控制。目标2将检查有和没有母亲的自我报告和观察到的生育差异。 OUD和意志测试母亲对婴儿线索的神经反应与自我报告和观察之间的关联 行为举止。目标3将研究母亲对婴儿线索的神经反应与婴儿社会行为之间的联系。 情感发展，以及母亲的养育和婴儿的社会情感发展之间，在这两个方面， 组探索性的目的将使用潜在的个人资料分析，以确定模式的神经反应，在母亲 并测试这些模式是否与母体OUD状态和妊娠有关。总的来说，这项研究 将在关键的产后时期确定母亲OUD的神经和行为相关性 这将促进目前对孕产妇OUD后果的了解，并为未来的干预措施提供信息， 有阿片类药物使用问题的母亲。因此，研究结果可以支持改善和预防 吸毒家庭对儿童的负面影响，包括吸毒疾患的代际传播， 母体阿片类药物成瘾根据这些研究目标，由赞助商支持的拟议培训计划 和另外五名教师专家，包括建立父母成瘾的实质性知识的目标， 亲子关系以及EEG/ERP测量和观察的方法技巧 考核这一建议将加强申请人的背景，并帮助启动她的研究生涯， 临床科学家专注于父母成瘾和预防成瘾的代际传递。

Project Summary Opioid use disorder (OUD) is a major public health problem with a high cost burden and multi- generational adverse consequences. In particular, rates of OUD during pregnancy and postpartum have quadrupled in the last two decades and pose a critical threat to maternal caregiving during the sensitive period of infancy. While extant research points to the negative effects of maternal addiction on parenting behavior and child outcomes—including increased risk of later substance use problems in offspring—little is known about the caregiving effects of maternal addiction to opioids in particular. This gap in research extends to our understanding of neural mechanisms that underlie caregiving behavior, which have yet to be examined in mothers with OUD. In line with NIDA’s Strategic Objectives 1.3 and 4.1, the overall goal of the proposed multi-method research study is to provide novel data on the specific early caregiving consequences of maternal OUD across neural, behavioral, and self-report levels of analysis. As an add-on to an existing study of maternal opioid use trajectories following pregnancy, this study will evaluate neural and behavioral caregiving indicators at 5-months postpartum, and infant socio-emotional development at 6-months postpartum, in mothers receiving medication assisted treatment (MAT) for OUD and demographically-matched control mothers without OUD. Aim 1 will utilize event- related potentials (ERP) to examine differences in neural response to infant cues in mothers with OUD compared to controls. Aim 2 will examine differences in self-reported and observed caregiving in mothers with and without OUD and will test associations between mothers’ neural responses to infant cues and self-reported and observed caregiving behavior. Aim 3 will examine links between mothers’ neural responses to infant cues and infant socio- emotional development, and between maternal caregiving and infant socio-emotional development, in both groups. The exploratory aim will use latent profile analysis to identify patterns of neural responses in mothers and test whether these patterns are associated with maternal OUD status and caregiving. Overall, this research will identify neural and behavioral caregiving correlates of maternal OUD during the critical postpartum period that will advance current knowledge on the consequences of maternal OUD and inform future interventions with mothers with opioid use problems. Findings can therefore support efforts to improve caregiving and prevent negative child outcomes, including the intergenerational transmission of substance use disorders, in families with maternal opioid addiction. In line with these study aims, the proposed training plan, supported by the sponsor and five additional faculty experts, includes goals to build substantive knowledge in parental addiction and parent-infant relationships as well as methodological skills in EEG/ERP measurement and observational assessment. This proposal will strengthen the applicant’s background and help launch her research career as a clinical scientist focused on parental addiction and prevention of the intergenerational transmission of addiction.