Affective And Cognitive Processes Postpartum In Mothers With Opioid Use Disorder

7.项目总结/摘要 目前的阿片类药物流行越来越多地影响育龄妇女和孕妇， 迫切需要确定最佳方法来支持正在养育子女的阿片类药物使用障碍（OUD）妇女。 虽然人们理解，患有开放式发育障碍的妇女及其子女面临着重大挑战，但这些挑战的性质 人们对这些挑战知之甚少，因此难以为这一群体提供有针对性的干预措施。的 Mayes及其同事提出的成瘾父母的奖励-压力失调模型强调奖励 敏感性和压力反应是成瘾和养育子女的重叠核心过程。模型 假设低奖励敏感性和高应激反应的妇女与物质使用 困难会导致养育困难，并增加持续成瘾行为的可能性。的 拟议的项目将审查这一模式的几个关键要素，仍然未经测试，并考虑的作用， 抑制控制是执行功能的关键组成部分，在成瘾和成瘾中起着重要作用。 和为人父母该项目的重点是产后时期作为一个关键的时间出现的养育 行为和母亲与婴儿之间情感联系和依恋的形成。之前 研究强调，产后时期是核心神经系统行为和生物可塑性提高的时期。 认知和情感过程与成瘾和养育有关。因此，它代表了一个有潜力的时代 脆弱性和机会，为妇女和他们的孩子。拟议项目将采用 前瞻性纵向设计，检查核心认知和情感过程，奖励敏感性，压力 反应/调节和抑制控制，在产后第一年的妇女（N=60）和没有 OUD（N=60）。评估将在妊娠晚期以及产后6周、6个月和12个月进行。 我们将对感兴趣的结构进行多模式评估。我们将研究 这些认知和情感的过程，以表征可塑性在产后期间，并确定 对有和没有开放式发展障碍的妇女的这些过程的轨迹作出贡献的关键背景因素。 我们将考虑奖励敏感性、压力反应性和抑制控制之间的相互作用如何与 母亲的养育行为以及这些过程在多大程度上解释了养育子女的差异， 母婴依恋和情感联系的妇女与没有OUD。最后我们将 在有（N=30）和没有（N=30）的女性子样本中使用功能性磁共振成像 OUD探索核心认知和情感过程的潜在神经回路。 研究核心认知和情感过程如何与新生儿父母行为和婴儿- OUD女性的母亲依恋将填补科学理解中的一个重大空白， 药物使用影响家庭。该项目与中心的更大努力相吻合， 提供信息，以便利在时间和目标方面日益精确的干预努力， 患有OUD的女性在养育子女时所面临的独特挑战。

7. PROJECT SUMMARY/ABSTRACT The current opioid epidemic increasingly impacts women of childbearing age and pregnant women, creating an urgent need to identify optimal ways to support women with opioid use disorder (OUD) who are parenting. While it is understood that women with OUD and their children face significant challenges, the nature of these challenges are poorly understood, making it difficult to provide targeted interventions for this population. The reward-stress dysregulation model of addicted parenting put forth by Mayes and colleagues highlights reward sensitivity and stress reactivity as overlapping core processes involved in addiction and parenting. The model postulates that low reward sensitivity and heightened stress reactivity among women with substance use difficulties will contribute to parenting difficulties and increased likelihood of ongoing addictive behaviors. The proposed project will examine several key elements of this model that remain untested, and consider the role of inhibitory control, a key component of executive functioning, which plays an important role in both addiction and parenting. The project focuses on the postpartum period as a critical time for the emergence of parenting behaviors and formation of emotional connectedness and attachment between mother and infant. Prior research highlights the postpartum period as a time of heightened behavioral and biological plasticity for core cognitive and affective processes relevant to addiction and parenting. As such, it represents a time of potential vulnerability and opportunity for women with OUD and their children. The proposed project will employ a prospective longitudinal design to examine core cognitive and affective processes, reward sensitivity, stress reactivity/regulation and inhibitory control, over the first year postpartum in women with (N=60) and without OUD (N=60). Assessments will occur in late pregnancy and at 6-weeks, 6-months and 12-months postpartum. We will employ multimodal assessment of the constructs of interest. We will examine longitudinal trajectories of these cognitive and affective processes to characterize plasticity during the postpartum period, and to identify key contextual factors contributing to the trajectory of these processes for women with OUD and without OUD. We will consider how interactions between reward sensitivity, stress reactivity and inhibitory control relate to maternal parenting behaviors and the extent to which these processes explain differences in parenting and infant-maternal attachment and emotional connectedness for women with versus without OUD. Finally, we will employ functional magnetic resonance imaging in a subsample of women with (N=30) and without (N=30) OUD to explore the underlying neurocircuitry of the core cognitive and affective processes of interest. Examination of how core cognitive and affective processes relate to emerging parenting behaviors and infant- maternal attachment for women with OUD will fill a significant gap in the scientific understanding of how substance use impacts families. This project dovetails with the larger efforts of the Center by providing critical information to facilitate increasingly precise intervention efforts, with regard to timing and targets, to address the unique challenges of women with OUD who are parenting.