Affective And Cognitive Processes Postpartum In Mothers With Opioid Use Disorder

7. 项目总结/文摘

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.