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

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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.