Mood, mother, and child: The psychobiology of dyadic resilience

摘要：情绪、母亲和孩子：二元复原力的心理生物学 在美国，围产期抑郁症(PND)每年影响40多万对母婴， 造成毁灭性的后果。患有PND的母亲对婴儿需求的敏感度降低，增加了婴儿风险 情绪调节受损和不安全的依恋。这些失调的相互作用在第一年 生活与认知和社会情感发展受损有关，包括儿童精神病 和执行功能受损(EF)。经历过PND的母亲更有可能继续或 复发性抑郁症和焦虑症，增加进一步的风险。然而，尽管暴露在PND中， 一些二联体完好无损地出现。这项研究的长期目标是确定心理生物学 暴露在PND和长期母亲抑郁中的母子二人组的韧性基础 和焦虑轨迹(MDAT)。该提案的目标是描述MDAT的异构性 在儿童生命的前5年，确定调解人，解释通过什么机制 MDAT影响儿童的结果，并确定可以作为干预点的主持人以促进 二元复原力。我们将利用现有的情绪、母婴(MMI)研究参与者 (R01HD073220，mmi.web.unc.edu，Pi Stuebe)，这是一项我们领导的正在进行的纵向队列研究 在产后第一年进行了广泛表型的母婴双生子(N=222)。我们的 中心假说是催产素在二联征发育中起着核心作用，其指标是 OT心理生物学、遗传学和表观遗传学，以及MDAT和儿童发展结果。其基本原理是 因为这项工作是，我们的发现将为有针对性的干预提供信息，以促进弹性并减少 母亲抑郁的后遗症。我们将通过实现以下目标来实现我们的申请目标 通过MMI跟踪研究--情绪、母婴研究(MMC)--的具体目标：1)阐明OT的作用 在母亲的心理生物学基础上的MDAT和父母行为，包括影响 外源性催产素(OT)对HPA轴反应性的影响2)确定HPA轴反应性的社会心理调节因子 MDAT与儿童发展结果之间的联系；以及3)决定儿童 OXT和OXTR型调节MDAT、敏感性、依恋质量和 发育结果；量化儿童在OT和OXTR中的表观遗传学变化调节的程度 MDAT与发育结局之间的关联。这项工作的预期结果将是 抑郁和抑郁对母婴影响的预测和保护因素的测定 焦虑，为促进复原力的新方法奠定了基础。这样的结果将会产生积极的影响 通过告知干预措施来防止抑郁和焦虑的代际传播，从而产生影响。

ABSTRACT: MOOD, MOTHER AND CHILD: THE PSYCHOBIOLOGY OF DYADIC RESILIENCE Perinatal depression (PND) affects more than 400,000 mother-infant dyads in the US each year, with devastating consequences. Mothers with PND exhibit reduced sensitivity to infant needs, increasing infant risk for impaired emotional regulation and insecure attachment. These dysregulated interactions in the first year of life are associated with impaired cognitive and socioemotional development, including child psychopathology and impaired executive function (EF). Mothers who experience PND are more likely to have continuing or relapsing depression and anxiety disorders, conferring further risk. Nevertheless, despite exposure to PND, some dyads emerge intact. The long-term goal of this research is to identify the psychobiological underpinnings of resilience among mother-child dyads exposed to PND and longer-term maternal depression and anxiety trajectories (MDATs). The objectives of this proposal are to characterize MDAT heterogeneity during the first 5 years of the child’s life, to identify mediators that explain the mechanisms through which MDATs influence child outcomes, and identify moderators that may serve as intervention points for promoting dyadic resilience. We will leverage an existing pool of participants in the Mood, Mother and Infant (MMI) study (R01HD073220, mmi.web.unc.edu, PI Stuebe), an ongoing longitudinal cohort study that we have led of mother-infant dyads (N=222) who have been extensively phenotyped during the first postpartum year. Our central hypothesis is that oxytocin plays a central role in dyadic development, indexed by associations between OT psychobiology, genetics and epigenetics and both MDATs and child development outcome. The rationale for this work is that our findings will inform targeted interventions to facilitate resilience and diminish the sequelae of maternal depression. We will accomplish the objective of our application by pursuing the following specific aims via an MMI follow-up study, the Mood, Mother and Child (MMC) study: 1) Elucidate the role of OT in the maternal psychobiological underpinnings of MDATs and parenting behavior, including effects of exogenous oxytocin (OT) on HPA axis reactivity; 2) Determine psychosocial mediators and moderators of associations between MDATs and child developmental outcome; and 3) Determine the extent to which child OXT and OXTR genotype moderates associations between MDATs, sensitivity, attachment quality, and developmental outcome; quantify the extent to which child epigenetic changes in OT and OXTR mediate associations between MDATs and developmental outcome. The expected outcomes of this work will be the determination of both predictive and protective factors for mother-infant dyads affected by depression and anxiety, laying the groundwork for novel approaches to promote resilience. Such results will have a positive impact by informing interventions to prevent intergenerational transmission of depression and anxiety.