Daily dynamics of suicide risk, dysregulation, and sleep disruption across the transition to parenthood

项目总结 自杀占产妇产后死亡的20%-30%，是 新妈妈。尽管存在这种国家健康危机，但目前的自杀研究严重忽视了孕妇的样本 和产后妇女。迫切需要确定导致这一人群自杀风险的因素； 然而，目前的围产期研究受到单一诊断方法和自我测量能力差的限制。 伤害性思想和行为(SITB)。此外，自杀研究总体上迫切需要 方法上的进步，因为对自杀企图的预测能力没有提高。这个项目将 通过实施创新的多时间尺度设计来推动这些研究领域的发展 在围产期重复测量妇女的SITB和相关危险因素。具体地说，睡眠 将测量干扰(例如，睡眠质量差、夜间频繁唤醒)和情绪失调， 因为它们是公认的SITB的跨诊断风险因素，与围产期高度相关 句号。参加家长R01研究(R01MH119070)的18至39岁孕妇将被招募 为了这个项目。他们将佩戴手腕活动记录仪进行客观的睡眠-觉醒测量并完成简报 第三天7天的早晚睡眠、情绪调节障碍和性功能障碍调查 妊娠三个月、产后6周、产后4个月。这三个时间点在 围产期，由于睡眠结果在妊娠晚期显著下降，抑郁症状通常 在产后6周左右发育，3周以后几乎没有关于女性心理健康的研究。 产后几个月，尽管有证据表明大多数母亲的自残死亡发生在9至12个月之间 产后。这项短期的纵向研究将使用动态系统建模来说明时间 女性睡眠、情绪失调和SITB之间的关系(目标1和2)，以及睡眠和 情绪失调会随着时间的推移影响SITB(目标3)。动力系统建模在自杀和 围产期心理健康研究，并提供了一种创新的方法来表征结构如何相互作用和 随着时间的推移而改变。此外，这个项目的多时间尺度设计提供了一个关键的机会来揭示 孩子的出生可能会如何改变这些结构之间的动态。鉴于中国的自杀率不断上升 育龄妇女以及产妇死亡对儿童和家庭的毁灭性后果，这 该项目解决了迫切需要了解在向为人父母的转变过程中出现自杀现象的问题。 当这个项目的目标实现时，将为未来的研究和干预奠定基础。 旨在减少围产期窘迫和产妇自残死亡。

PROJECT SUMMARY Suicide accounts for 20-30% of maternal postpartum deaths, and is the second leading cause of death among new mothers. Despite this national health crisis, current suicide research sorely neglects samples of pregnant and postpartum women. There is urgent need to identify factors contributing to suicide risk in this population; however, current perinatal research is limited by single-diagnostic approaches and poor measurement of self- injurious thoughts and behaviors (SITBs). In addition, suicide research, in general, is in dire need of methodological advancement, as predictive ability for suicide attempts has not improved. This project will advance these fields of research by implementing an innovative multiple time-scale design that captures repeated measures of women’s SITBs and relevant risk factors across the perinatal period. Specifically, sleep disturbances (e.g., poor sleep quality, frequent nightly awakenings) and emotion dysregulation will be measured, as they are well-established transdiagnostic risk factors for SITBs that are highly relevant across the perinatal period. Pregnant women aged 18 to 39 who are enrolled in a parent R01 study (R01MH119070) will be recruited for this project. They will wear wrist actigraphs for objective sleep-wake measurements and complete brief morning and evening surveys on their sleep, emotion dysregulation, and SITBs for 7 days during the third trimester, 6 weeks postpartum, and 4 months postpartum. These three time points are meaningful across the perinatal period, as sleep outcomes decrease substantially by third trimester, depressive symptoms often develop around 6 weeks postpartum, and there is virtually no research on women’s mental health beyond 3 months postpartum, despite evidence that most maternal self-harm deaths occur between 9 and 12 months postpartum. This short-term longitudinal study will use dynamical systems modeling to illuminate temporal relations between women’s sleep, emotion dysregulation, and SITBs (Aims 1 and 2), as well as how sleep and emotion dysregulation influence SITBs over time (Aim 3). Dynamical systems modeling is nascent in suicide and perinatal mental health research, and offers an innovative approach to characterize how constructs interact and change over time. Moreover, this project’s multiple time-scale design affords a critical opportunity to uncover how the birth of a child may change the dynamics between these constructs. Given rising rates of suicide among women of childbearing age as well as devastating consequences of maternal death on children and families, this project addresses an urgent need to understand the emergence of suicidality across the transition to parenthood. When the aims of this project are realized, there will be a foundation for future research and interventions designed to reduce perinatal distress and maternal self-harm-related deaths.