Elucidating Mechanisms of Pregnancy's Protective Effect on Drug Abuse Using Integrated Data Analysis

项目摘要/摘要 怀孕对女性吸烟和其他药物使用的显著保护作用是常见的 一种未被研究的现象，在这种现象中，上瘾的过程在缺乏 治疗。识别潜在的机制将为成瘾过程如何 更有效地被颠覆。 为了加快这一目标的进展并克服先前研究的方法论局限性，我们 重新调整多个具有独特功能的现有数据集的用途，以实现我们的目标。具体来说，我们会： 1.利用人内设计来估计怀孕的独特“影响”，以及 怀孕，与单次怀孕期间的吸烟行为有关。 2.通过以下方式分离和评估一般的和育儿相关的发展影响对吸烟的影响 检查在两次怀孕时接受评估的一组妇女的两次怀孕之间的差异。 3.检查根据现有黄金标准定性访谈编码的产前反思功能的作用， 在怀孕对吸烟的保护作用方面。 目标1和目标2将首次提供怀孕与吸烟相互作用的准确时间和方式的估计 行为，为今后明确新干预目标的工作奠定了基础。就像反射功能是 已知使用孕妇在实质上是可塑性的，了解其在与怀孕相关的 吸烟的改变将为新的戒烟干预措施提供基础。 这一创新方案融合了梅西博士(Dr.Massey)日常临床工作产生的假说， 一位具有尖端量化和方法论专业知识的成瘾精神病学家 严格测试流行病学家艾伦博士(MPI)提供的这些假设。要整合的队列包含 短期(怀孕期间)和长期(多胎妊娠)纵向数据，最先进的 药物暴露措施，以及由经验丰富的母亲提供的定性和定量母亲数据 成熟的发育科学家团队：Neiderhiser博士(Co-I)、Eiden博士(Co-I)和Wakschlag博士(Co-I)。 由于数据最初是在NIDA的支持下开发的，以检查接触毒品的儿童，他们 独一无二地适用于单独和联合检查药物。从这项研究中获得的知识需要改进 并使产前干预措施个人化，并指导未来对与接触有关的后代的调查 结果。阐明怀孕对药物使用的保护作用的潜在机制也告诉我们 更广泛地理解社交过程如何成功地与令人上瘾的过程竞争。

PROJECT SUMMARY/ABSTRACT The notable protective effect of pregnancy on women’s tobacco and other drug use is a common yet understudied phenomenon in which addictive processes are temporarily attenuated in the absence of treatment. Identifying underlying mechanisms would provide novel insights into how addictive processes could be more effectively disrupted. To accelerate progress towards this goal and overcome methodologic limitations of prior studies, we repurpose multiple existing datasets with unique features to accomplish our aims. Specifically, we will: 1. Utilize a within-person design to estimate the unique “effect” of pregnancy, and salient events of pregnancy, on smoking behavior within a single pregnancy. 2. Isolate and estimate the impact of general and parenting-related developmental influences on smoking by examining between-pregnancy differences in a subset of women who were assessed on two pregnancies. 3. Examine the role of prenatal reflective functioning, coded from existing gold-standard qualitative interviews, in pregnancy’s protective effect on smoking. Aims 1 & 2 will provide the first ever estimates of precisely when and how pregnancy interacts with smoking behavior, setting the stage for future work to specify novel intervention targets. As reflective functioning is known to be malleable in substance using pregnant women, understanding its role in pregnancy-associated change in smoking will provides the foundation for novel smoking cessation interventions. This innovative proposal blends hypotheses generated from Dr. Massey’s (MPI) day-to-day clinical work as an addiction psychiatrist with the cutting-edge quantitative and methodological expertise necessary to rigorously test these hypotheses provided by epidemiologist Dr. Allen (MPI). Cohorts to be integrated contain short-term (within pregnancy) and long-term (across multiple pregnancies) longitudinal data, state-of-the-art drug exposure measures, and both qualitative and quantitative maternal data contributed by an experienced team of established developmental scientists: Drs. Neiderhiser (Co-I), Eiden (Co-I), and Wakschlag (Co-I). As data were originally developed with NIDA’s support to examine drug-exposed children, they are uniquely suited to examine drugs alone, and in combination. Knowledge from this study is needed to improve and personalize prenatal interventions and to guide future investigations of exposure-related offspring outcomes. Elucidating mechanisms underlying pregnancy’s protective effect on drug use also informs a broader understanding of how social processes successfully compete with addictive processes.