Reducing Fetal Exposure to Maternal Depression to Improve Infant Risk Mechanisms

项目总结/摘要 暴露于母亲抑郁症状是最确定的风险因素之一， 儿童后期心理病理学的发展。从自然观察研究中积累证据 文件表明，胎儿暴露于母亲抑郁症状与日后儿童精神疾病的风险有关， 健康问题母亲抑郁症是最常见的产前并发症之一， 40%的女性经历抑郁症状水平升高。过去的大多数研究 相关性，因此潜在的因果关系结论有限。这个项目将通过测试 操纵母亲抑郁症状将有利于婴儿结局的假设。在这个项目中， 产妇抑郁症状将减少使用简短的人际关系治疗（IPT），一个完善的， 有效的治疗，并测试这种减少是否会导致婴儿发育的改善 与以后精神病理学风险相关的机制。符合NIMH的研究优先级 领域标准（RDoC）为基础的过程，我们将评估婴儿的多个措施，评估 来自负价系统的潜在威胁（“焦虑”）和来自负价系统的认知（努力）控制 认知系统。我们建议评估300名报告抑郁水平升高的孕妇， 症状和婴儿。在干预之前，将收集产妇测量数据。然后一半的 妇女将随机接受IPT，另一半将接受加强的常规护理。完成后 在干预措施中，将纵向收集产后14个月的产妇测量结果。婴儿 将在出生时以及7个月和14个月矫正年龄时进行评估。婴儿将在四个单位进行评估， 分析（大脑结构和功能，生理学，行为和母亲报告）。

Project Summary/Abstract Exposure to maternal depressive symptoms is one of the most well established risk factors for the development of later child psychopathology. Accumulating evidence from naturalistic observational studies documents that fetal exposure to maternal depressive symptoms is associated with risk for later child mental health problems. Maternal depression is one of the most common prenatal complications with approximately 40% of women experiencing elevated levels of depressive symptoms. The majority of past research has been correlational, so potential causal conclusions have been limited. This project will break new ground by testing the hypothesis that manipulating maternal depressive symptoms will benefit infant outcomes. In this project, maternal depressive symptoms will be reduced using brief interpersonal therapy (IPT), a well-established and efficacious treatment, and testing whether this reduction leads to an improvement in the development of infant mechanisms associated with risk for later psychopathology. Consistent with NIMH's priority of Research Domain Criteria (RDoC)-based processes, we will assess infants with multiple measures that assess the constructs of potential threat (“anxiety”) from the Negative Valence System and cognitive (effortful) control from the Cognitive System. We propose to assess 300 pregnant women who report elevated levels of depressive symptoms and their infants. Prior to the intervention, maternal measures will be collected. Then half of the women will be randomized to receive IPT and the other half will receive enhanced usual care. After completion of the intervention, maternal measures will be collected longitudinally through 14 months postpartum. Infants will be evaluated at birth and at 7- and 14-months corrected age. Infants will be assessed across four units of analysis (brain structure and function, physiology, behavior, and maternal-report).