Affective And Cognitive Processes Postpartum In Mothers With Opioid Use Disorder

7.项目摘要/摘要 目前的阿片类药物流行越来越多地影响育龄妇女和孕妇，造成 迫切需要确定支持阿片类药物使用障碍(OUD)妇女育儿的最佳方式。 虽然人们理解，患有胎儿窘迫症的妇女及其子女面临重大挑战，但这些挑战的性质 人们对挑战知之甚少，因此很难为这一人群提供有针对性的干预措施。这个 Mayes和他的同事提出的成瘾父母的奖励-压力失调模型突出了奖励 敏感度和压力反应性是成瘾和养育子女的重叠核心过程。模型 假设有药物使用的女性对奖励的敏感度较低，应激反应增强 困难将导致育儿困难和持续成瘾行为的可能性增加。这个 提议的项目将检查此模型的几个关键元素，这些元素仍未经过测试，并考虑其作用 抑制控制是执行功能的一个关键组成部分，它在两种成瘾中都发挥着重要作用 和养育子女。该项目的重点是产后时期，作为育儿方式出现的关键时期。 母婴之间的情感连接和依恋的行为和形成。之前 研究强调，产后是核心的行为和生物可塑性增强的时期 与成瘾和养育有关的认知和情感过程。因此，它代表了一个有潜力的时代 怀孕妇女及其子女的脆弱性和机会。拟议的项目将雇用一名 前瞻性纵向设计，考察核心认知和情感过程、奖励敏感性、压力 产后一年的反应性/调节和抑制性控制：有无产后妇女(N=60) OUD(N=60)。评估将在怀孕后期以及产后6周、6个月和12个月进行。 我们将对感兴趣的结构进行多模式评估。我们将检查其纵向轨迹 这些认知和情感过程来表征产后可塑性，并识别 关键的背景因素有助于这些进程的轨迹，对有和没有无有。 我们将考虑奖励敏感性、应激反应和抑制控制之间的交互作用如何与 母亲的育儿行为以及这些过程在多大程度上解释了养育方式和 母婴依恋与情绪连通性在母婴依恋及情绪连通性上的比较。最后，我们会 对患有功能性磁共振成像的女性(N=30)和非女性(N=30)进行功能磁共振成像 探索感兴趣的核心认知和情感过程的潜在神经回路。 研究核心认知和情感过程如何与新出现的育儿行为和婴儿相关。 对患有先天性巨结肠的女性的母性依恋将填补科学理解中的一个重大空白 物质使用会影响家庭。该项目与中心的更大努力相吻合，提供了关键的 提供信息，以促进在时机和目标方面日益精确的干预努力，以解决 有孩子的女性所面临的独特挑战。

7. PROJECT SUMMARY/ABSTRACT The current opioid epidemic increasingly impacts women of childbearing age and pregnant women, creating an urgent need to identify optimal ways to support women with opioid use disorder (OUD) who are parenting. While it is understood that women with OUD and their children face significant challenges, the nature of these challenges are poorly understood, making it difficult to provide targeted interventions for this population. The reward-stress dysregulation model of addicted parenting put forth by Mayes and colleagues highlights reward sensitivity and stress reactivity as overlapping core processes involved in addiction and parenting. The model postulates that low reward sensitivity and heightened stress reactivity among women with substance use difficulties will contribute to parenting difficulties and increased likelihood of ongoing addictive behaviors. The proposed project will examine several key elements of this model that remain untested, and consider the role of inhibitory control, a key component of executive functioning, which plays an important role in both addiction and parenting. The project focuses on the postpartum period as a critical time for the emergence of parenting behaviors and formation of emotional connectedness and attachment between mother and infant. Prior research highlights the postpartum period as a time of heightened behavioral and biological plasticity for core cognitive and affective processes relevant to addiction and parenting. As such, it represents a time of potential vulnerability and opportunity for women with OUD and their children. The proposed project will employ a prospective longitudinal design to examine core cognitive and affective processes, reward sensitivity, stress reactivity/regulation and inhibitory control, over the first year postpartum in women with (N=60) and without OUD (N=60). Assessments will occur in late pregnancy and at 6-weeks, 6-months and 12-months postpartum. We will employ multimodal assessment of the constructs of interest. We will examine longitudinal trajectories of these cognitive and affective processes to characterize plasticity during the postpartum period, and to identify key contextual factors contributing to the trajectory of these processes for women with OUD and without OUD. We will consider how interactions between reward sensitivity, stress reactivity and inhibitory control relate to maternal parenting behaviors and the extent to which these processes explain differences in parenting and infant-maternal attachment and emotional connectedness for women with versus without OUD. Finally, we will employ functional magnetic resonance imaging in a subsample of women with (N=30) and without (N=30) OUD to explore the underlying neurocircuitry of the core cognitive and affective processes of interest. Examination of how core cognitive and affective processes relate to emerging parenting behaviors and infant- maternal attachment for women with OUD will fill a significant gap in the scientific understanding of how substance use impacts families. This project dovetails with the larger efforts of the Center by providing critical information to facilitate increasingly precise intervention efforts, with regard to timing and targets, to address the unique challenges of women with OUD who are parenting.