Investigating the effects of depression on contraceptive behaviors

18-24岁的女性中，68%的怀孕是意外的，这个年龄段的美国女性中大约有四分之一在过去一年中有过抑郁发作。心理学和生殖健康交叉领域的许多研究都集中在抑郁症作为生育，意外怀孕，不孕症或避孕药使用等生殖健康经历的结果。相比之下，K 01指导研究科学家发展奖的重点是将抑郁症概念化为年轻女性意外怀孕的前兆，因为使用避孕需要知识，动机和抑郁症患者可能缺乏的代理感。为了更好地理解生育理论，并将人口统计学观点纳入我的工作，我建议开展以下职业发展活动：1）获得人口和人口统计学研究和方法方面的正式培训，2）对抑郁症在意外怀孕中的作用进行合理的概念化，3）扩展我的统计技能，包括纵向和中介分析，（4）学习和积累定性方法的经验。这些研究活动是对这些培训目标的补充，包括：1）调查抑郁症影响避孕行为的程度，如避孕方法的选择，避孕方法的使用模式，方法中断和不一致的使用，2）使用定量和定性方法来检查抑郁症影响避孕行为的潜在机制，（3）开展并试点一项前瞻性队列研究，调查抑郁症个体内变化相对于其他重要解释因素影响避孕行为变化的程度和机制。这些努力将受益于由世界知名学者组成的顾问委员会，包括主要导师Nancy Adler博士，共同导师Jennifer Johnson-Hanks博士，科学顾问James Trussell博士和科学顾问Tina Raine-Bennett博士。此外，教师顾问Chuck McCulloch博士，Owen Wolkowitz博士和Judith Barker博士将分别提供统计分析技术，抑郁症临床方面和定性方法的专业知识。精神病学的UCSF部门将提供基础设施，以支持这些活动。本K 01中建议的培训和研究活动将促进 我转变为一名独立调查员，他采取跨学科和多方法的方法来理解生殖健康的心理方面，并将扩大我们对导致意外怀孕的原因的理解。

DESCRIPTION (provided by applicant): Sixty-eight percent of pregnancies among women ages 18-24 are unintended, and approximately one quarter of U.S. women in this age group have had a depressive episode in the past year. Much research at the intersection of psychology and reproductive health has focused on depression as an outcome of reproductive health experiences such as childbirth, unintended pregnancy, infertility, or contraceptive use. In contrast, this K01 Mentored Research Scientist Development Award focuses on conceptualizing depression as a precursor to unintended pregnancy among young women because using contraception requires knowledge, motivation, and a sense of agency that depressed individuals may lack. To better understand theories of fertility and to integrate demographic perspectives into my work, I propose the following career development activities: 1) obtain formal training in population and demographic research and methods, 2) develop a sound conceptualization of the role of depression in unintended pregnancy, 3) extend my statistical skill set to include longitudinal and mediational analyses, and 4) learn about and gain experience with qualitative methods. The research activities complement these training goals and are: 1) to investigate the extent to which depression influences contraceptive behaviors such as choice of contraceptive method, contraceptive use patterns, method discontinuation, and inconsistent use, 2) to use quantitative and qualitative methods to examine potential mechanisms by which depression influences contraceptive behaviors, and 3) to develop and pilot a prospective cohort study to investigate the extent to which and mechanisms by which intra-individual changes in depression influence changes in contraceptive behaviors relative to other significant explanatory factors. These endeavors will benefit from an advisory board comprised of world-renown scholars including primary mentor Nancy Adler, PhD, co-mentor Jennifer Johnson-Hanks, PhD, scientific advisor James Trussell, PhD, and scientific advisor Tina Raine-Bennett, MD. In addition, faculty consultants Chuck McCulloch, PhD, Owen Wolkowitz, MD, and Judith Barker, PhD will provide expertise in statistical analysis techniques, clinical aspects of depression, and qualitative methods, respectively. The UCSF Department of Psychiatry will provide the infrastructure to support these activities. The training and research activities proposed in this K01 will facilitate my transition to an independent investigator who takes an interdisciplinary and multi-method approach to understanding psychological aspects of reproductive health and will broaden our understanding of what leads to unintended pregnancy.