Effects of maternal opioid use disorder on neural and behavioral indicators of caregiving

项目摘要 阿片类药物使用障碍(OUD)是一大公共卫生问题，具有高成本负担和多方面的特点。 世代相传的不利后果。特别是，怀孕期间和产后的OUD比率 在过去20年里翻了两番，在敏感时期对产妇护理构成了严重威胁 婴儿期的。而现有的研究指出，母亲成瘾对育儿行为和 儿童结局--包括后代日后出现物质使用问题的风险增加--鲜为人知 尤其是母亲对阿片类药物成瘾的照顾效果。这一研究上的差距延伸到了我们对 照顾行为的神经机制，这一点还没有在患有先天性巨结肠的母亲身上进行检查。 根据NIDA的战略目标1.3和4.1，拟议的多方法研究的总体目标 这项研究是为了提供关于母亲OUD在神经中的特定早期照顾后果的新数据， 行为和自我报告的分析水平。作为对母亲阿片类药物使用轨迹的现有研究的补充 怀孕后，这项研究将评估产后5个月的神经和行为照顾指标， 在接受药物辅助的母亲中，产后6个月的婴儿社会情绪发育 治疗(MAT)：无胎龄儿和人口学上匹配的对照母亲。目标1将利用事件- 相关电位(ERP)检测母亲与母体对婴儿线索反应的差异 到控制程序。目标2将检验有无母亲在自我报告和观察到的照顾方面的差异 并将测试母亲对婴儿暗示的神经反应与自我报告和观察之间的联系 照顾他人的行为。目标3将研究母亲对婴儿暗示的神经反应与婴儿社交反应之间的联系 情绪发展，以及母亲照料和婴儿社会情绪发展之间的关系 组。探索性的目标是使用潜伏期分析来识别母亲的神经反应模式 并测试这些模式是否与母亲的地位和照顾有关。总体而言，这项研究 将确定产后关键时期母亲的神经和行为照顾的相关性 这将促进目前对孕产妇OUD后果的了解，并为未来的干预提供信息 有阿片类药物使用问题的母亲。因此，研究结果可以支持改善护理和预防的努力 儿童不良结局，包括物质使用障碍的代际传递，在患有 母亲的阿片成瘾。根据这些研究目标，拟议的培训计划得到主办方的支持 和五名额外的教员专家，包括建立关于父母成瘾的实质性知识和 亲子关系以及脑电/事件相关电位测量和观察的方法学技能 评估。这项建议将加强申请人的背景，并有助于启动她的研究生涯 临床科学家专注于父母成瘾和预防成瘾的代际传播。

Project Summary Opioid use disorder (OUD) is a major public health problem with a high cost burden and multi- generational adverse consequences. In particular, rates of OUD during pregnancy and postpartum have quadrupled in the last two decades and pose a critical threat to maternal caregiving during the sensitive period of infancy. While extant research points to the negative effects of maternal addiction on parenting behavior and child outcomes—including increased risk of later substance use problems in offspring—little is known about the caregiving effects of maternal addiction to opioids in particular. This gap in research extends to our understanding of neural mechanisms that underlie caregiving behavior, which have yet to be examined in mothers with OUD. In line with NIDA’s Strategic Objectives 1.3 and 4.1, the overall goal of the proposed multi-method research study is to provide novel data on the specific early caregiving consequences of maternal OUD across neural, behavioral, and self-report levels of analysis. As an add-on to an existing study of maternal opioid use trajectories following pregnancy, this study will evaluate neural and behavioral caregiving indicators at 5-months postpartum, and infant socio-emotional development at 6-months postpartum, in mothers receiving medication assisted treatment (MAT) for OUD and demographically-matched control mothers without OUD. Aim 1 will utilize event- related potentials (ERP) to examine differences in neural response to infant cues in mothers with OUD compared to controls. Aim 2 will examine differences in self-reported and observed caregiving in mothers with and without OUD and will test associations between mothers’ neural responses to infant cues and self-reported and observed caregiving behavior. Aim 3 will examine links between mothers’ neural responses to infant cues and infant socio- emotional development, and between maternal caregiving and infant socio-emotional development, in both groups. The exploratory aim will use latent profile analysis to identify patterns of neural responses in mothers and test whether these patterns are associated with maternal OUD status and caregiving. Overall, this research will identify neural and behavioral caregiving correlates of maternal OUD during the critical postpartum period that will advance current knowledge on the consequences of maternal OUD and inform future interventions with mothers with opioid use problems. Findings can therefore support efforts to improve caregiving and prevent negative child outcomes, including the intergenerational transmission of substance use disorders, in families with maternal opioid addiction. In line with these study aims, the proposed training plan, supported by the sponsor and five additional faculty experts, includes goals to build substantive knowledge in parental addiction and parent-infant relationships as well as methodological skills in EEG/ERP measurement and observational assessment. This proposal will strengthen the applicant’s background and help launch her research career as a clinical scientist focused on parental addiction and prevention of the intergenerational transmission of addiction.