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

项目摘要 产后抑郁症（PPD）因其患病率而备受关注，特别是 高危女性群体。PPD与以下物质的不太理想的相互作用有关： 婴儿，包括更大的消极性和更多的脱离母亲。这些品质 相互作用与发展和心理健康的不利结果有关， 孩子因此，阐明增加有问题的相互作用的风险的因素是至关重要的。 本研究的目的是描述母婴互动的质量， 产后抑郁症高危妇女，决定了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 的PPD和母婴互动质量之间的关联的主持人。 这些调节因素包括精神健康问题，这些问题是与 母亲的抑郁症（焦虑和药物滥用），她面临的逆境（贫困，缺乏 家庭/伴侣支持和创伤史），以及婴儿的性别，新生儿健康状况， 气质我们还将通过比较以下方面的差异， 婴儿6个月与1岁时各种关系的强度。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个研究中心，共同产生样本量，具有检查多个 关联和测试调节效应。样本包括749名高危妇女 抑郁症，因为以前诊断的情绪障碍，暴露于虐待，或 一个医学上脆弱的婴儿的诞生这项研究的最初18个月将涉及对母亲的评级- 使用NICHD母婴互动量表，合并 将单个研究数据纳入合并的REDCap数据库，并开发相应的 在所有抑郁症和调节变量的研究中使用通用指标进行测量。 分析和解释汇总数据，以检查研究目标将发生在最后6 个月衡量模式将采用各种方法，包括标准化方法。 因子分析和项目反应分析。结构方程模型将用于 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）提高母亲和婴儿的识别能力， 相互作用可能是最容易受到PPD的影响，和2）使定制的 干预措施，以减少婴儿的风险，为以后发展的精神病理学，已 与抑郁的母亲有关

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.