2/2 Predictors and Course of Postpartum Obsessions and Compulsions

2/2 产后强迫症的预测因素和过程

• 批准号: 10612420
• 负责人: GERALD NESTADT
• 金额: $ 40.57万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10612420
• 关键词: Adverse effects; Allopregnanolone; Anxiety; Attitude; Belief; Biological; Biological Factors; Biological Markers; Biological Phenomena; Budgets; CSF3 gene; Characteristics; Child; Child Rearing; Childbirth; Childhood; Clinical; Clinical Research; Clinical Trials; Data Analyses; Data Analytics; Development; Disease susceptibility; Empirical Research; Ensure; Estradiol; Frequencies; Fright; Future; Granulocyte-Macrophage Colony-Stimulating Factor; IL8 gene; Individual; Infant; Infant Health; Inflammatory; Infrastructure; Interleukin-15; Interleukin-6; Life; Life Stress; Link; Locales; Long-Term Effects; Maternal Health; Mediator; Mental Depression; Mental Health; Mental disorders; Mothers; Nature; Negative Valence; Newborn Infant; North Carolina; Obsession; Outcome; Patient Self-Report; Perinatal; Personal Satisfaction; Phenotype; Physiology; Postpartum Period; Pregnancy; Prevention; Prevention program; Progesterone; Prospective Studies; Psychological Factors; Public Health; Research; Research Domain Criteria; Research Personnel; Risk; Risk Factors; Risk Reduction; Ritual compulsion; Role; Rural; Sampling; Severities; Site; Symptoms; TNF gene; Time; Training; United States National Institutes of Health; Universities; Woman; Work; adverse outcome; antenatal; anxious; chemokine; compulsion; cytokine; data management; depressive symptoms; evidence base; experience; improved; interest; maternal stress; middle childhood; multidisciplinary; obstetric outcomes; perinatal period; peripartum depression; postnatal; prenatal; prospective; psychologic; psychosocial; recruit; response; screening program; treatment program; unborn child

Project Summary/Abstract Obsessional anxiety and compulsive rituals arising during pregnancy and the postpartum have a significant detrimental short-term impact on the well-being of the mother, the pregnancy, the unborn child, and the newborn infant. They also can have negative long-term effects on maternal and infant health, as well as on the mother-infant relationship and on into childhood. Although research has focused on perinatal depressive and anxious states, there is now strong evidence that obsessions and compulsions (OCS) are precipitated or exacerbated by pregnancy and childbirth and may have a deleterious impact on mother and infant. Despite an increased risk of developing OCS during pregnancy and postnatally (i.e., the perinatal period), there is almost no empirical research on its predictors and precursors, how it is related to other postpartum negative valence states such as anxiety and depression, or the specific impact of postpartum OCS on the mother. Accordingly, we will prospectively examine the predictive utility of psychological and biological phenomena (e.g., self-report, physiology) empirically linked to perinatal/postpartum OCS (pOCS), anxiety, and depression, and how these states relate with one another. We also aim to evaluate the extent to which pOCS manifest adverse effects on functionally-related outcomes of significant public health concern, such as obstetric outcomes, maternal health, maternal attitudes, and parenting behaviors during the first year of life. Consistent with the Research Domain Criteria (RDoC) framework, women will be screened antenatally for diatheses empirically demonstrated to predispose to the development or exacerbation of pOCS; and that are thus hypothesized to also put one at risk for pOCS. High- and low-risk groups will be followed during pregnancy and for 6 months postpartum, and repeatedly assessed to identify those experiencing more frequent, intense, and prolonged pOCS and the variables associated with such problems. The two recruitment sites for this study are the University of North Carolina (UNC) at Chapel Hill and Johns Hopkins University (JHU). JHU will provide data management and analytic support. Considering estimates of the high rates of pOCS, together with the limited available information on this subject, the results of this study will help clinicians and researchers 1) use psychological and biological markers elucidated in the current study to identify women at increased risk of developing OCD and its adverse consequences, and 2) reduce the risk of developing OC symptoms in pregnancy, and its adverse consequences, by modifying these psychological and biological factors prior to pregnancy, and in the early prenatal period. Moreover, the risk factors elucidated in this study may be applicable to development of non-pregnancy- related OC symptoms.

项目摘要/摘要 孕期和产后出现的强迫性焦虑和强迫仪式 对母亲、怀孕、儿童的健康产生重大的短期有害影响 未出生的孩子和新生的婴儿。它们也可能对产妇产生负面的长期影响。 和婴儿健康，以及母婴关系和儿童时期。虽然 研究集中在围产期抑郁和焦虑状态，现在有强有力的证据 强迫症和强迫症(OCS)会因怀孕和 分娩，并可能对母亲和婴儿产生有害影响。尽管风险增加了 在孕期和产后(即围产期)发生OCS时，几乎没有 其预测因子和先兆的实证研究及其与其他产后阴性的关系 情绪状态，如焦虑和抑郁，或产后OCS对 母亲。因此，我们将前瞻性地检验心理和心理的预测效用。 与围产期/产后相关的生物学现象(如自我报告、生理学) OCS(POCS)、焦虑和抑郁，以及这些状态是如何相互关联的。我们也 目的评估POC在多大程度上表现出与功能相关的不良反应 重大公共卫生问题的结果，如产科结果、产妇健康、 母亲的态度，以及生命第一年的育儿行为。与 研究领域标准(RDoC)框架，将对女性进行素质筛查 经验性证明易导致POC的发展或恶化； 因此假设也会使其中一个处于POC的风险中。高危人群和低风险人群将受到关注 在怀孕期间和产后6个月，反复评估以确定 经历更频繁、更强烈和更长时间的POC以及与此相关的变量 有问题。这项研究的两个招聘地点是北卡罗来纳大学(UNC)，地址为 教堂山和约翰霍普金斯大学(JHU)。JHU将提供数据管理和分析 支持。考虑到对高POC比率的估计，以及现有的有限 关于这一主题的信息，这项研究的结果将帮助临床医生和研究人员使用 在目前的研究中阐明了心理和生物标记物，以识别女性 增加患强迫症的风险及其不良后果，以及2)降低患强迫症的风险 通过改变这些因素，在怀孕期间出现OC症状及其不良后果 孕前和孕期早期的心理和生物因素。此外， 本研究阐明的危险因素可能适用于非妊娠期疾病的发生。 相关的OC症状。