1/2 Predictors and Course of Postpartum Obsessions and Compulsions

项目摘要/摘要 孕期和产后出现的强迫焦虑和强迫仪式对 对母亲、孕妇、未出生的婴儿和新生儿的福祉产生有害的短期影响 婴儿。它们还可能对母婴健康以及母亲-- 婴儿之间的关系，一直持续到童年。尽管研究的重点是围产期抑郁和焦虑 在美国，现在有强有力的证据表明，强迫症和强迫症(OCS)是由 怀孕和分娩，并可能对母亲和婴儿产生有害影响。尽管风险增加了 在孕期和产后(即围产期)发生OCS，几乎没有经验 对其预测因子和先兆的研究，以及它与其他产后负价态的关系 焦虑和抑郁，或产后OCS对母亲的具体影响。因此，我们将 前瞻性地检查心理和生物现象的预测效用(例如，自我报告， 生理学)经验性地与围产期/产后OCS(POCS)、焦虑和抑郁有关，以及这些因素是如何 国家之间相互联系。我们还旨在评估POC在多大程度上表现出对 重大公共卫生关切的职能相关结果，如产科结果、产妇健康、 母亲的态度，以及生命第一年的育儿行为。与研究领域保持一致 标准(RDoC)框架，将对女性进行经验性证明的糖尿病筛查 易导致POC的发展或恶化；因此假设也会使一个人处于危险之中 对于POC。高风险组和低风险组将在孕期和产后6个月内进行跟踪调查，并 反复评估以确定那些经历更频繁、更强烈和更长时间的POC和 与这类问题相关的变数。这项研究的两个招聘地点是诺斯大学 北卡罗来纳州(北卡罗来纳州)教堂山和约翰霍普金斯大学(JHU)。JHU将提供数据管理和 分析支持。考虑到对高POC比率的估计，以及有限的可用信息 在这个问题上，这项研究的结果将帮助临床医生和研究人员1)使用心理学和生物学 在目前的研究中阐明的标记物可以识别患强迫症及其不良反应风险增加的女性 减少怀孕期间出现强迫症症状的风险及其不良后果， 通过在怀孕前和早期产前改变这些心理和生物因素。 此外，本研究中阐明的危险因素可能适用于非妊娠相关疾病的发展。 OC症状。

Project Summary/Abstract Obsessional anxiety and compulsive rituals arising during pregnancy and the postpartum have a significant detrimental short-term impact on the well-being of the mother, the pregnancy, the unborn child, and the newborn infant. They also can have negative long-term effects on maternal and infant health, as well as on the mother- infant relationship and on into childhood. Although research has focused on perinatal depressive and anxious states, there is now strong evidence that obsessions and compulsions (OCS) are precipitated or exacerbated by pregnancy and childbirth and may have a deleterious impact on mother and infant. Despite an increased risk of developing OCS during pregnancy and postnatally (i.e., the perinatal period), there is almost no empirical research on its predictors and precursors, how it is related to other postpartum negative valence states such as anxiety and depression, or the specific impact of postpartum OCS on the mother. Accordingly, we will prospectively examine the predictive utility of psychological and biological phenomena (e.g., self-report, physiology) empirically linked to perinatal/postpartum OCS (pOCS), anxiety, and depression, and how these states relate with one another. We also aim to evaluate the extent to which pOCS manifest adverse effects on functionally-related outcomes of significant public health concern, such as obstetric outcomes, maternal health, maternal attitudes, and parenting behaviors during the first year of life. Consistent with the Research Domain Criteria (RDoC) framework, women will be screened antenatally for diatheses empirically demonstrated to predispose to the development or exacerbation of pOCS; and that are thus hypothesized to also put one at risk for pOCS. High- and low-risk groups will be followed during pregnancy and for 6 months postpartum, and repeatedly assessed to identify those experiencing more frequent, intense, and prolonged pOCS and the variables associated with such problems. The two recruitment sites for this study are the University of North Carolina (UNC) at Chapel Hill and Johns Hopkins University (JHU). JHU will provide data management and analytic support. Considering estimates of the high rates of pOCS, together with the limited available information on this subject, the results of this study will help clinicians and researchers 1) use psychological and biological markers elucidated in the current study to identify women at increased risk of developing OCD and its adverse consequences, and 2) reduce the risk of developing OC symptoms in pregnancy, and its adverse consequences, by modifying these psychological and biological factors prior to pregnancy, and in the early prenatal period. Moreover, the risk factors elucidated in this study may be applicable to development of non-pregnancy-related OC symptoms.