1/2 Predictors and Course of Postpartum Obsessions and Compulsions

项目总结/摘要 强迫性焦虑和强迫性仪式发生在怀孕期间和产后有显着 对母亲、怀孕、未出生的孩子和新生儿的福祉产生不利的短期影响 婴儿。它们还可能对孕产妇和婴儿的健康以及母亲的健康产生长期的负面影响。 从婴儿时期到童年时期。虽然研究集中在围产期抑郁和焦虑 美国，现在有强有力的证据表明，强迫症和强迫症（OCS）是沉淀或加剧 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， 在怀孕期间和出生后发展OCS（即，围产期），几乎没有经验 研究其预测因素和前兆，它是如何与其他产后负价状态，如 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）经验上与围产期/产后OCS（pOCS），焦虑和抑郁有关，以及这些 国家之间相互联系。我们还旨在评估pOCS对以下方面的不良影响程度： 具有重大公共卫生关切的功能相关结局，如产科结局、孕产妇健康， 母亲的态度和养育行为在生命的第一年。与研究领域一致 标准（RDoC）框架，妇女将在产前筛查经验证明的素质， 易患pOCS的发展或恶化;因此假设也会使人处于危险之中 对于pOCS。高危和低危人群将在怀孕期间和产后6个月内接受随访， 反复评估，以确定那些经历更频繁，更强烈和更长时间pOCS的患者， 与这些问题相关的变量。这项研究的两个招募地点是北 卡罗莱纳（北）在查佩尔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pOCS高发生率的估计，以及有限的可用信息， 在这个问题上，这项研究的结果将有助于临床医生和研究人员1）使用心理和生物 在目前的研究中阐明的标志物，以确定妇女在发展强迫症的风险增加， 后果，和2）减少在怀孕期间发生OC症状的风险，及其不良后果， 通过在怀孕前和产前早期改变这些心理和生物因素。 此外，本研究中阐明的风险因素可能适用于非妊娠相关性 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.