Moderators of Maternal Depression's Relationship to Mother-Infant Interaction

项目总结： -- 产后抑郁(PPD)因其患病率而备受关注，尤其是 在女性的高危人群中。PPD与不太理想的交互有关， 婴儿，包括更多的消极情绪和更多的母亲脱离。这些品质 相互作用与发展和心理健康的不良后果有关 孩子们。因此，阐明增加问题交互作用风险的因素是至关重要的。 本研究的目的是描述儿童母婴互动的质量。 PPD的高危女性，决定母亲抑郁的严重程度 症状可能与这些相互作用有关，并基于理论和经验进行测试 产后抑郁与母婴互动质量之间的关系的基础调解人。 这些主持人包括精神健康问题，这些问题是与 母亲的抑郁(焦虑和药物滥用)，她暴露在逆境中(贫穷，缺乏 家庭/伴侣支持和精神创伤史)，以及婴儿的性别、新生儿健康和 性情。我们还将通过比较婴儿发育的差异来研究婴儿发育的作用。 当婴儿6个月和1岁时，各种关系的强度。这项研究 将利用来自7项研究的现有数据集和视频记录的丰富基础 3个站点，它们共同产生了足够大的样本大小来检查多个 关联和测试缓和效果。样本包括749名高危女性 由于之前诊断出的情绪障碍，暴露于虐待，或 一个医学上脆弱的婴儿的出生。这项研究的最初18个月将包括对母亲的评级- 使用NICHD母婴互动量表记录的婴儿互动，合并 将个人研究数据放入一个汇集的RedCap数据库中，并开发相应的 在所有抑郁症和缓解变量的研究中，使用共同的指标进行衡量。 对汇集的数据进行分析和解释以检查研究目标将在最后6期中进行 月份。测量模型将采用各种方法，包括标准化 得分、因素分析和项目反应分析。将使用结构方程建模来 检查目标，同时描述和调整研究间异质性的来源。 这项研究有可能1)提高对母亲和婴儿的识别能力 相互作用可能最容易受到PPD的影响，以及2)允许定制 干预措施，以降低婴儿后来发展为精神病理学的风险 与母亲的抑郁联系在一起。

Project Summary    Depression during the postpartum (PPD) is of great concern based on its prevalence, especially in high risk groups of women. PPD has been associated with less optimal interactions with infants, including greater negativity and more disengagement of mothers. These qualities of interaction have been linked to adverse outcomes for the development and mental health of children. Thus, elucidating factors that heighten risk for problematic interactions is essential. The purpose of this study is to characterize the qualities of mother-infant interaction among women at high risk for PPD, determine the degree to which severity of mothers' depressive symptoms may be associated with these interactions, and test theory-based and empirically based moderators of the association between PPD and the quality of mother-infant interactions. These moderators include mental health problems that are common co-morbidities with a mother's depression (anxiety and substance abuse), her exposure to adversity (poverty, lack of family/partner support, and history of trauma), and the infant's gender, neonatal health, and temperament. We will also examine the role of infant development, by comparing differences in the strength of various relationships when the infant is 6 months versus 1 year of age. The study will capitalize on a rich foundation of existing datasets and video-records from 7 studies across 3 sites that, together, yield a sample size with the necessary power to examine multiple associations and test moderating effects. The sample includes 749 women who are at high risk for depression because of a previously diagnosed mood disorder, exposure to abuse, or the birth of a medically fragile infant. The initial 18 months of the study will involve ratings of mother- infant video-recorded interactions using the NICHD Mother-Infant Interaction Scales, merging of individual study data into a pooled REDCap database, and development of commensurate measures with common metrics across studies for all depression and moderating variables. Analysis and interpretation of pooled data to examine the research aims will occur in the final 6 months. The measurement model will employ varied methodologies, including standardized scores, factor analysis and item response analysis. Structural equation modeling will be used to examine the aims, while delineating and adjusting for sources of between-study heterogeneity. This research has the potential to 1) improve identification of mothers and infants whose interactions may be most vulnerable to the effects of PPD, and 2) enable the tailoring of interventions to reduce the infant's risk for later development of psychopathology that has been associated with having a depressed mother.