Neurophysiological Social Reward Processing, Birth Trauma, and Depression Symptoms in the Peripartum Period

项目摘要/摘要 围产期抑郁(即怀孕期间和分娩后的抑郁；产后抑郁)很普遍， 对女人来说很虚弱。产后抑郁与严重的负面后果有关，包括功能障碍 母亲的自杀风险以及对婴儿的认知、发育、情感和社会影响。 在围产期影响女性的另一个常见因素是分娩创伤。近一半的女性 分娩支持分娩创伤，包括分娩并发症、违反 期望，或需要加强医疗救治。怀孕期间的抑郁是一个已知的危险因素 出生创伤。此外，出生创伤与母亲和子女的一系列不良后果有关。 与PPD的效果相似。许多支持分娩创伤的女性没有患上产后抑郁，这引发了问题 关于抑郁症的脆弱性，这可能会导致产后抑郁与分娩创伤的相互作用。漏洞- 抑郁症的压力模型认为抑郁症是潜在的脆弱性之间相互作用的结果 和压力。越来越多的证据支持使用神经科学方法来识别抑郁症易感性 在整个发育过程中，比如神经奖赏反应性降低。此外，压力会缓和 对随后的抑郁进行奖励处理。奖赏处理可能与产后精神障碍的出生创伤相互作用 症状。作为一个更大项目的一部分，该项目使用一种新颖的方法来测量神经社会奖励反应。 和生态有效的范例，基于背景因素客观编码的分娩创伤，以及抑郁 对120名母亲的症状进行了评估。抑郁症状和诊断是在怀孕期间收集的 和产后。在产后8周的评估中，参与者完成了一项新的社交发明 延迟任务，同时记录脑电以响应奖励(即，指向照片的绿色箭头 参与者的婴儿)和中性反馈(即指向岩石照片的红色箭头)。事件相关电位 (例如，奖励积极性，奖励响应性的时间域度量)和时频数据(即， Delta活动，一个对奖励敏感的频域标记)用于测量神经生理学 对社会奖励的回应。此外，参与者完成出生体验访谈以获取维度 出生创伤(即总体严重程度、违反预期和失控)。该项目审查了 低社会奖赏反应性(目标1)和分娩创伤(目标2)对产后抑郁症状的影响 治疗怀孕期间的抑郁症状。此外，该项目还测试了出生创伤作为 社会奖励反应和产后抑郁症状之间的关系，解释了 妊娠期抑郁症状(目标3)。这个项目汇集了各自领域的专家和 允许接受关于压力和创伤在产后抑郁中的作用的高级培训、高级脑电方法和高级 数量化方法。该项目和培训提供了发展必要技能的机会 独立从事研究工作，确定导致产后抑郁风险的流程和环境因素。

PROJECT SUMMARY/ABSTRACT Peripartum depression (i.e., depression during pregnancy and following childbirth; PPD) is prevalent and debilitating for women. PPD is associated with significant negative outcomes, including functional impairment and suicidality risk in mothers as well as cognitive, developmental, emotional, and social impacts on infants. Another common factor impacting women during the peripartum period is birth trauma. Nearly half of women giving birth endorse birth trauma, including labor complications, emergency interventions that violate expectations, or needs for intensive medical treatment. Depression during pregnancy is a known risk factor for birth trauma. Further, birth trauma is associated with a range of adverse outcomes for mothers and offspring similar to the effects of PPD. Many women endorsing birth trauma do not develop PPD, raising questions about vulnerabilities for depression that may contribute to PPD in interaction with birth trauma. Vulnerability- stress models of depression posit depression is the result of interactions between underlying vulnerabilities and stress. Growing evidence supports the use of neuroscientific methods to identify depression vulnerabilities across development, such as reduced neural reward responsiveness. Further, stress moderates effect of reward processing on subsequent depression. Reward processing may interact with birth trauma on PPD symptoms. As part of a larger project, this project measures neural social reward responsiveness using a novel and ecologically valid paradigm, birth trauma objectively coded based on contextual factors, and depressive symptoms assessed in 120 mothers. Depression symptoms and diagnoses are collected across pregnancy and postpartum. During an assessment at 8 weeks postpartum, participants complete a novel social inventive delay task while electroencephalogram is recorded in response to reward (i.e., green arrow leading to a photo of participant’s infant) and neutral feedback (i.e., red arrow leading to a photo of rocks). Event-related potential (e.g., the reward positivity, a time-domain measure of reward responsiveness) and time-frequency data (i.e., delta activity, a frequency-domain marker of sensitivity to rewards) are used to measure neurophysiological response to social reward. Further, participants complete the Birth Experience Interview to capture dimensions of birth trauma (i.e., overall severity, violations of expectations, and loss of control). The project examines the effects of low social reward responsiveness (Aim 1) and birth trauma (Aim 2) on PPD symptoms, accounting for depressive symptoms during pregnancy. Further, the project tests birth trauma as a moderator of associations between social reward responsiveness and postpartum depressive symptoms, accounting for depressive symptoms during pregnancy (Aim 3). This project brings together experts in respective fields and allow for advanced training on the role of stress and trauma in PPD, advanced EEG methods, and advanced quantitative methods. The project and training provide opportunities to develop necessary skills for an independent career as a researcher identifying processes and environmental factors driving PPD risk.