Mother-Infant Biobehavioral Synchrony and Postpartum Depression

摘要 婴儿的大脑和调节系统在出生后的头几个月迅速发育，为健康成长奠定了基础。 行为和情感发展。研究表明，这些系统在很大程度上是由 产后的生活环境特别是，母婴互动的特点是共享 积极的情感和相互反应的行为促进了婴儿情绪自我调节的发展， 母婴对自我平衡和神经系统的共同调节。产后抑郁症（PPD） 然而，越来越多的证据表明，这些过程受到潜在的长期不利影响， 对婴儿的影响。然而，仍然存在着几个关键的差距。首先，我们对神经基质知之甚少， 尽管便携式神经成像工具的最新进展有希望（即，近红外 光谱[NIRS]超扫描）。其次，虽然积极的价值系统是健康的基础， 调整和基于力量的亲子行为干预，研究主要集中在 负面情绪和赤字模型第三，缺乏纵向研究， 协同调节行为和PPD严重程度的变化，可以为预防干预提供信息。拟议 这项研究旨在填补这些空白，并得到了初步概念验证数据的支持， 在内侧额叶和外侧额叶区域显示出一致的反应，这与社会认知有关， 结合和心理化，积极的同步互动增强了这些一致的反应。的 具体目标是：1）描述母婴生物行为同步性（情感行为和情感行为的匹配） 产后3个月时的脑反应）; 2）检查PPD之间的并发和前瞻性关联 严重程度和母婴积极的生物行为同步;和3）检查改善的程度 在母婴中，积极生物行为同步性预测婴儿情绪调节。使用病例对照 设计中，我们将招募176名支持PPD的女性（研究完成时n=140）和87名既往无PPD的女性。 3个月大婴儿的抑郁症史（研究完成时n=70），并进行3次研究访视 在家庭环境中，增加难以接触和弱势家庭的参与。我们将评估 3个月、6个月和9个月时母婴面对面互动的生物行为同步性 母婴NIRS微分析编码将提供即时的措施，积极和消极的 近红外光谱将提供母亲和婴儿的二元一致性的措施， 前内侧和外侧前额叶皮质活动。PPD的变化将通过临床访谈进行评估， 除了3至9个月的每月筛查外，每次家访。婴儿的情绪自我调节将是 在9个月时通过独立观察和母体报告进行评估。

ABSTRACT Infant brain and regulatory systems develop rapidly in the first months of life and set the stage for healthy behavioral and emotional development. Research shows that these systems are shaped, to a large extent, by the postpartum caregiving environment. In particular, mother-infant interactions that are characterized by shared positive affect and mutually responsive behavior facilitate the development of infant emotional self-regulation via mother-infant co-regulation of homeostatic and neural systems. In the context of postpartum depression (PPD) however, growing evidence suggests that these processes are disrupted with potentially long-term adverse implications for the infant. However, several critical gaps remain. First, little is known about the neural substrates of dyadic co-regulation despite the promise of recent advances in portable neuroimaging tools (i.e., near-infrared spectroscopy [NIRS] hyperscanning). Second, although positively valenced systems are fundamental to healthy adjustment and to strengths-based parent-child behavioral interventions, research has focused predominantly on negative affect and deficit models. Third, there is a lack of longitudinal research examining developmental change in co-regulatory behaviors and PPD severity that could inform preventive interventions. The proposed study aims to fill these gaps, and is supported by preliminary proof-of-concept data that mothers and children show concordant responding in medial frontal and lateral frontal regions, which are implicated in social cognition, bonding, and mentalizing, and that positive synchronous interactions heighten these concordant responses. The Specific Aims are to: 1) Characterize mother-infant bio-behavioral synchrony (matching of affective behavior and brain response) at 3 months postpartum; 2) Examine concurrent and prospective associations between PPD severity and mother-infant positive bio-behavioral synchrony; and 3) Examine the extent to which improvements in mother-infant positive bio-behavioral synchrony predict infant emotional regulation. Using a case-control design, we will recruit 176 women endorsing PPD (n=140 at study completion) and 87 women with no prior history of depression (n=70 at study completion) with their 3-month-old infants and conduct three research visits in the home environment to increase participation of difficult-to-reach and vulnerable families. We will assess bio-behavioral synchrony in mother-infant face-to-face interactions at 3-, 6- and 9-months during simultaneous mother-infant NIRS. Micro-analytic coding will provide moment-to-moment measures of positive and negative affect and contingent responding, and NIRS will provide measures of dyadic concordance in mother and infant anterior medial and lateral prefrontal cortical activity. Change in PPD will be assessed via clinical interviews at each home visit, in addition to monthly screening from 3 to 9 months. Infant emotional self-regulation will be assessed at 9 months via independent observations and maternal report.