Predicting Risk for Peripartum Depression Through Trajectories of Emotional Reactivity to Infant Distress Cues

通过对婴儿痛苦线索的情绪反应轨迹预测围产期抑郁的风险

• 批准号: 10056940
• 负责人: AUTUMN J KUJAWA
• 金额: $ 41.93万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-05-15 至 2023-05-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10056940
• 关键词: Animal Experimentation; Arousal; Attention; Auditory; Behavioral; Birth; Brain; Child; Child Abuse and Neglect; Child Rearing; Childbirth; Complication; Cross-Sectional Studies; Crying; Cues; Detection; Development; Diagnostic; Disease; Distress; Emotional; Emotions; Environment; Event-Related Potentials; Exposure to; Face; Human; Impairment; Individual Differences; Infant; Intercept; Interview; Lead; Life; Life Stress; Longitudinal Studies; Measures; Mental Depression; Methods; Mothers; National Institute of Mental Health; Neurobiology; Pattern; Performance; Perinatal; Personal Satisfaction; Physiological; Postpartum Depression; Postpartum Period; Pregnancy; Pregnant Women; Prevention; Process; Public Health; Questionnaires; Reaction Time; Recording of previous events; Research; Risk; Sampling; Schedule; Second Pregnancy Trimester; Shapes; Symptoms; System; Testing; Third Pregnancy Trimester; Time; Visit; Visual; Woman; associated symptom; behavioral response; childhood adversity; comorbidity; critical period; depressive symptoms; emotional stimulus; experience; heart rate variability; improved; motherhood; multimodality; neuroimaging; offspring; peripartum depression; relating to nervous system; response; sound; suicidal risk; trend

PROJECT SUMMARY Postpartum depression (PPD) is a prevalent disorder associated with impairments in maternal functioning, risk of suicide and comorbidity, and negative effects on offspring development. The peripartum period is marked by dramatic neurobiological changes, yet the impact of these changes on emotional reactivity remain poorly understood. Longitudinal research examining dynamic change across this period is critically needed to chart trajectories of change and determine when women at risk for PPD can be reliably identified in order to facilitate effective timing of prevention to mitigate risk. To this end, we have developed and tested the feasibility of a method for measuring neural, physiological, and behavioral responses to highly-salient emotional stimuli for pregnant women and new mothers (i.e., infant distress cues). We will assess 100 pregnant women at 20 weeks gestation (2nd trimester; time 1). We will oversample for depression risk, such that at least 50% of the sample will have a history of treatment for depression, elevated current depressive symptoms, and/or history of childhood adversity. A second session will be scheduled for 34 weeks gestation (3rd trimester; time 2), and a final session will be scheduled for 8 weeks postpartum (time 3). At each assessment, women will complete an infant face matching task in which they match distressed, happy, and neutral infant faces and shapes with and without interspersed infant crying sounds. Repeated assessments using this task will allow us to chart peripartum trajectories of emotional reactivity with the potential to improve prediction of PPD. Event-related potentials (ERPs), particularly the late positive potential (LPP), a reliable measure of motivated attention and arousal processes, will be used to measure emotional reactivity at the neural level. Heart rate variability (HRV) decreases from the no-cry to cry condition will measure physiological responses to infant distress. Finally, increases in reaction time (RT) when matching faces in the cry vs. no-cry condition will be a behavioral indicator of emotional reactivity. At time 1, diagnostic interviews will assess lifetime depression history, and new onsets of depressive episodes will be assessed at time 2 and 3. For sensitive detection of PPD symptoms, women will complete depressive symptom measures through an electronic questionnaire the week following childbirth and continuing biweekly for 8 weeks. This project will allow us to chart trajectories of neural, physiological, and behavioral reactivity to infant distress cues across pregnancy and into the postpartum period (Specific Aim 1). In addition, we will test competing predictors of PPD symptoms considering both time 1 neural, physiological, and behavioral reactivity to infant distress, as well as change in reactivity to infant distress from mid-pregnancy to postpartum (Specific Aim 2). This exploratory project will integrate an ecologically-valid emotion paradigm with longitudinal, multimodal assessment and be the first to chart trajectories of change in emotional reactivity across the peripartum period to improve prediction of PPD.

项目摘要 产后抑郁症（PPD）是一种与母体功能障碍相关的常见疾病， 以及对后代发育的负面影响。围产期的特点是 戏剧性的神经生物学变化，但这些变化对情绪反应的影响仍然很差 明白迫切需要对这一时期的动态变化进行纵向研究， 变化的轨迹，并确定何时可以可靠地识别处于PPD风险中的妇女，以促进 有效的预防时机，以减轻风险。为此，我们开发并测试了 用于测量对高度突出的情绪刺激的神经、生理和行为反应的方法， 孕妇和新妈妈（即，婴儿痛苦线索）。我们将评估100名20岁的孕妇 妊娠周（第2个三月;时间1）。我们将对抑郁风险进行过度抽样，这样至少有50%的人 样本将具有抑郁症治疗史、当前抑郁症状升高和/或 童年的不幸第二阶段将安排在妊娠34周（妊娠晚期;时间2）， 最后一次治疗将安排在产后8周（时间3）。在每次评估中，女性将完成一项 婴儿面部匹配任务，在该任务中，他们将悲伤、快乐和中性的婴儿面部和形状与 没有婴儿的哭声。使用此任务进行重复评估将使我们能够绘制图表 围产期情绪反应的轨迹具有改善PPD预测的潜力。事件相关 电位（ERPs），特别是晚期正电位（LPP），这是一种可靠的测量动机性注意力的方法， 唤醒过程，将用于测量神经水平的情绪反应。心率变异性（HRV） 从不哭到哭状态的减少将测量对婴儿痛苦的生理反应。最后， 当在哭与不哭的条件下匹配面孔时，反应时间（RT）的增加将是一种行为 情绪反应的指标在时间1，诊断访谈将评估终身抑郁史， 在时间2和3评估抑郁发作的新发作。用于PPD的灵敏检测 症状，妇女将完成抑郁症状的措施，通过电子问卷的一周 分娩后，每两周持续8周。这个项目将使我们能够绘制神经， 生理和行为反应的婴儿痛苦线索在整个怀孕和进入产后期间 （具体目标1）。此外，我们将测试PPD症状的竞争预测因素，同时考虑时间1 对婴儿痛苦的神经、生理和行为反应，以及对婴儿痛苦反应的变化。 从怀孕中期到产后的痛苦（具体目标2）。这一探索性项目将整合一个 生态有效的情感范式与纵向，多模式评估，并成为第一个图表 在整个围产期情绪反应的变化轨迹，以提高PPD的预测。