The effects of expressive writing following traumatic childbirth

项目总结 产妇分娩后的精神疾病与沉重的公共卫生负担有关。产后 精神病理学是导致产妇发病率和死亡率的主要因素，并可能危及儿童的 从出生起就幸福。这暗示了代际效应。虽然有努力减少产后 抑郁症，与分娩相关的创伤后应激障碍(CB-PTSD)，一种影响240,000人的疾病 美国妇女每年都得不到充分的诊断和治疗。慢性创伤后应激障碍的逆境被证明 通过1)慢性精神创伤后应激障碍症状的出现与婴儿出生之间密切的时间关系，2) 孩子本身成为不幸的，不断提醒人们创伤(分娩)，这可能会远离 母婴时期是母婴形成健康的纽带的重要时期 儿童发展。创伤后应激障碍的症状伴随着一个明显的触发事件，并在此期间出现早期症状 在经历了一次创伤后，为目标个人在 治疗可避免创伤后应激障碍症状轨迹的关键窗口。这意味着处于危险中的个人 可以在分娩后在医院进行接触和筛查，并接受早期干预以缓冲 CB-PTSD症状和优化母婴结局。在这个随机对照试验(RCT)中，我们 确定在分娩后数小时内有急性应激反应的个人，这表明存在 随后的慢性精神创伤后应激障碍。他们将被随机安排参加一次简短的表现力写作(EW)，内容是关于他们最近的 分娩或从产后第5天开始连续3天左右的中性体验(PP)。我们会 然后在重复的时间点跟踪他们，以评估即刻(第8天PP)和持续(MO)。2)治疗 效果。他们的婴儿将在墨尔本大学接受研究。2 PP检查干预对基础的影响 母婴纽带。母亲的CB-PTSD将使用心理诊断、心理测量学和 心理测量学和行为观察法在心理生理测量和母婴关系中的应用 对母子互动的评估。这项研究将开始填补干预措施方面的关键临床空白 支持创伤性分娩后产妇的心理健康，增加产妇复原力的机会 和心理上的成长。建立有效的干预措施，可能会导致实施外管局， 医院环境中符合母亲特殊需要的可行、成本效益高的治疗方法，从而 降低发生潜在的可预防的、代价高昂的创伤后精神障碍的几率，并促进健康 儿童发展。此外，这项拟议的研究还将进一步推动《消除对妇女一切形式歧视公约》的任务，即“妇女避免伤害 生殖过程和儿童的影响实现了健康和富有成效的生活。

PROJECT SUMMARY Maternal mental illness following childbirth is associated with substantial public health burden. Postpartum psychopathology is a leading contributor of maternal morbidity and mortality and can endanger the child’s wellbeing onward from birth. This suggests intergenerational effects. While efforts exist to reduce postpartum depression, childbirth-related posttraumatic stress disorder (CB-PTSD), a condition that affects 240,000 American women each year, is underdiagnosed and undertreated. The adversity of CB-PTSD is demonstrated by 1) the close temporal relationship between the onset of CB-PTSD symptoms and the birth of the infant, 2) the child themselves becoming an unfortunate, constant reminder of the trauma (childbirth), which can distance the mother from the child during an important time for the formation of mother-infant bonding instrumental for healthy child development. Symptoms of PTSD follow a distinct triggering event and early signs appear in the period after a traumatic experience, providing a unique opportunity for an intervention of targeted individuals during a critical window when treatment could avert the PTSD symptom trajectory. This means that at-risk individuals could be approached and screened in the hospital following childbirth and receive an early intervention to buffer CB-PTSD symptoms and optimize mother and child outcomes. In this randomized controlled trial (RCT), we identify individuals who have acute stress response in the hours following delivery indicative of risk for subsequent CB-PTSD. They will be randomized to take part in a brief expressive writing (EW) about their recent childbirth or about a neutral experience over 3 consecutive days starting from Day 5 postpartum (PP). We will then follow them at repeated time points, to assess immediate (Day 8 PP) and sustained (Mo. 2) treatment effects. Their infants will be studied at Mo. 2 PP to examine the influence of the intervention on the foundation of mother-infant bonding. Maternal CB-PTSD will be quantified using psychodiagnostic, psychometric, and psychophysiologic measures and mother-infant bonding using psychometrics and a behavioral observational assessment of mother-child interaction. This study will begin to fill the critical clinical gap in interventions to support maternal mental health following traumatic childbirth and enhance opportunities for maternal resilience and psychological growth. Establishing an effective intervention, may lead to the implementation of a safe, feasible, cost-effective therapy in hospital settings that is adherent to the special needs of mothers, thereby reducing the odds of developing a potentially preventable, costly, posttraumatic disorder and fostering healthy child development. In addition, the proposed study will further the NICHD missions that “women avoid harmful effects from reproductive processes and children achieve healthy and productive lives.”