Postpartum Intervention for Mothers with Opioid Use Disorders - Brain-Behavior Mechanisms

项目总结

Project Summary Postpartum Intervention for Mothers with Opioid Use Disorders - Brain-Behavior Mechanisms Opioid use disorder (OUD) is a fast-growing and devastating epidemic in the US with many suffering comorbid mood disorders. Despite receiving “gold standard” buprenorphine treatment to reduce withdrawal, OUD mothers still suffer have cravings, depression, impaired interpersonal interactions and maladaptive parenting behaviors that may lead to child maltreatment and costly utilization of foster care. We know that parenting interventions improve parent mood and sensitive caregiving behaviors for high-risk non-OUD populations. We developed “Mom Power” (MP), an evidence-based 13-session psychosocial mother-child intervention. We have established that MP enhances emotionally sensitive caregiving, while concurrently reducing parental stress and depression for non-OUD mothers. We also have preliminary feasibility data for MP with substance use disorders. However, we do not know about parenting interventions for mothers with OUD – specifically how virtual MP (vMP) will work to reduce drug use or improve mood. We also know about how the brain regulates parenting. Recent work from our team has established that a parenting intervention for non-OUD mothers was associated with a larger enhancement of evoke potential responses (ERPs) for emotional faces relative to neutral faces and that the magnitude of ERP responses to emotional faces was associated with observed maternal sensitivity. Using magnetic resonance imaging (MRI) of the brain, we have also established a Maternal Behavior Neurocircuit (MBN) that regulates flexible responses to the demands of their own infant – such as to the unique, ethologically salient own-baby cry and face stimuli during the early postpartum period. We have established MRI maternal brain changes associated with MP in non-OUD mothers, and brain effects of OUD on mothers. However, we do not know about parental brain mechanisms through which parenting interventions may work for mothers with OUD – whether they will affect ERP responses to baby stimuli or affect the MBN. Central hypotheses: Mothers with OUD who receive virtual MP (vMP), compared to matched controls, will show improved drug craving, mood, and stress symptoms, via changes in pre-specified MBN brain regions. In the high-risk R61 phase, we will establish if vMP (n=25) for OUD can be implemented and improve mood, reduce drug use and affect ERP brain responses to baby pictures compared with control (n=25). If hypotheses in the R61 are confirmed, we will confirm and expand this breakthrough with the R33 Phase (n=160, 80/group), adding richer maternal outcome measures and MBN MRI. This research will elucidate the effects of parenting intervention MP on drug use and brain function for OUD mothers - with translational potential for biomarker and treatment development.